Medical inquiries and observations

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MEDICAL INQUIRIES

AND

OBSERVATIONS.

BY BENJAMIN RUSH, M. D.

PROFESSOR OF THE INSTITUTES AND PRACTICE OF MEDICINE,

AND OF CLINICAL PRACTICE, IN THE UNIVERSITY

OF PENNSYLVANIA.

IN FOUR VOLUMES.
VOL. I.

THE SECOND EDITION,

REVISED AND ENLARGED BY THE AUTHOR.

PHILADELPHIA,

PUBLISHED BY J. CONRAD &, CO. CHESNUT-STREET, PHILADELPHIA ;
M. & J. CONRAD & CO. MARKET-STREET, BALTIMORE; RAPIN,
CONRAD, & CO. WASHINGTON; SOMERVELL & CONRAD, PETERS-
BURG; AND BONSAL, CoNRAD, & CO. NORFOLK.

PRINTED BY T. fc? G. PALMER, 116, HIGH-STREET.

1805.

PREFACE.

IN this second edition of the follow-
ing Medical Inquiries and Observations, the
reader will perceive many additions, some
omissions, and a few alterations.

A number of facts have been added to the
Inquiry into the Effects of Ardent Spirits
upon the Body and Mind, and to the Obser-
vations upon the Tetanus, Cynanche Tra-
chealis, and Old Age, in the first volume ;
also to the Observations upon Dropsies,
Pulmonary Consumption, and Hydrophobia,
contained in the second volume.

The Lectures upon Animal Life, which
were published, a few years ago, in a pam-

a

IV

phlet, have received no other additions than
a few notes.

The phenomena of fever have not only-
received a new title, but several new terms
have been adopted in detailing them, chiefly
to remove the mistake into which the use of
Dr. Brown's terms had led some of the au-
thor's readers, respecting his principles. A
new order has likewise been given, and
some new facts added, to the inquiry upon
this subject.

In the Account of the Yellow Fever of
1793, many documents, interesting to the
public at the time of their first publication,
are omitted \ and many of the facts and ob-
servations, which related to the origin of the
fevers of 1794 and 1797, now form a part
of a separate inquiry upon that subject, in
the fourth volume.

The histories of the yellow fever as epi-
demics, and of its sporadic cases, have been
published in the order in which they have ap-

peared in Philadelphia, to show the influence
of the weather upon it, and the impropriety
and danger of applying the same remedies
for the same epidemic, in different and even
successive seasons. The records of the
first cases of yellow fever, which have ap- *
peared in each of the twelve years that have
been noticed, are intended further to show
the inefficacy of all the means, at present
employed, to prevent its future recurrence?

In the fourth volume, the reader will find
a retraction of the author's former opinion
of the yellow fever's spreading by contagion.
He be^s forgiveness of the friends of science
aruLhumanity, if the publication of that opi-
nion has had any influence in increasing
the misery and mortality attendant upon that
disease. Indeed, such is the pain he feels,
in recollecting that he ever entertained or
propagated it, that it will long, and perhaps
always, deprive him of the pleasure he might
otherwise have derived from a review of his
attempts to fulfil the public duties of his pro-
fession.

VI

Considerable additions are made to the'
facts and arguments in favour of the domes-
tic origin of the yellow fever, and to the
Defence of Blood-letting.

The Account of the Means of Preventing
the Usual Forms of Summer and Autumnal
Disease, appears for the first time in this
edition of the author's Inquiries. Part of
the facts intended to prove the yellow fever
not to be contagious, were published in the
sixth volume of the New-York Medical Re-
pository. The reader will perceive, among
many additions to them, answers to all the
arguments usually employed to defend the
contrary opinion.

The Inquiry into the Comparative State
of Medicine, in Philadelphia, between the
years 1760 and 1766, and 1805, was deli-
vered, in the form of an oration, before the
Medical Society of Philadelphia, on the 18th
of February, 1804. Some things have been
omitted, and a few added, in the form in
which it is now offered to the public.

vu

If this edition of Medical Inquiries and
Observations should be less imperfect than
the former, the reader is requested to ascribe
it to the author having profited by the ob-
jections he encouraged his pupils to make
to his principles, in their inaugural disserta-
tions, and in conversation ; and to the many
useful facts which have been communicated
to him by his medical brethren, whose names
have been mentioned in the course of the
work.

For the departure, in the modes of prac-
tice adopted or recommended in these In-
quiries, from those which time and experience
have sanctioned, in European and in East
and West-Indian countries, the author makes
the same defence of himself, that Dr. Bag-
livi made, near a century ago, of his modes
of practice in Rome. " Vivo et so'ibo in aere
Romano" said that illustrious physician.
The author has lived and written in the cli-
mate of Pennsylvania, and in the city of
Philadelphia.

November 18^/z, 1805.

CONTENTS OF VOLUME I.

page
AN inquiry into the natural history of medicine

among the Indians of North- America, and a com-
parative view of their diseases and remedies with
those of civilized nations 1

An account of the climate of Pennsylvania, and its
influence upon the human body 69

An account of the bilious remitting fever, as it ap-
peared in Philadelphia in the summer and autumn
of 'the year 1780 115

An account of the scarlatina anginosa, as it appeared
in Philadelphia in the years 1783 and 1784 135

An inquiry into the cause and cure of the cholera in-
fantum 153

Observations on the cynanche trachealis 167

An account of the efficacy of blisters and bleeding, in
the cure of obstinate intermitting fevers 177

An account of the disease occasioned by drinking cold
water in warm weather, and the method of curing
it 181

An account of the efficacy of common salt in the cure
of hemoptysis 1 89

X

page
Thoughts on the cause and cure of pulmonary con-
sumption 197
Observations upon worms in the alimentary canal,

and upon anthelmintic medicines 215*

An account of the external use of arsenic in the cure

of cancers 235

Observations on the tetanus 245

The result of observations made upon the diseases
which occurred in the military hospitals of the
United States, during the revolutionary war 267

An account of the influence of the military and politi-
cal events of the American revolution upon the hu-
man body 277
An inquiry into the relation of tastes and aliments to
each other, and into the influence of this relation
upon health and pleasure 295
The new method of inoculating for the small-pox 309
An inquiry into the effects of ardent spirits upon the
human body and mind, with an account of the
means of preventing, and the remedies for curing
them 335
Observations on the duties of a physician, and the
methods of improving medicine; accommodated to
the present state of society and manners in the
United States 385
An inquiry into the causes and cure of sore legs 401
An account of the state of the body and mind in old
age, with observations on its diseases, and their
remedies 425

AN INQUIRY

INTO THE

NATURAL HISTORY OF MEDICINE

AMONG THE

INDIANS OF NORTH- AMERICA;

AND A

COMPARATIVE VIEW

OF THEIR

DISEASES AND REMEDIES WITH THOSE OF
CIVILIZED NATIONS.

Read before the American Philosophical Society, held at
Philadelphia, on the 4th of February, 1774,

VOL. I.

AN INQUIRY, &c.

Gentlemen*-,

I RISE with peculiar diffidence to address you
upon this occasion, when I reflect upon the enter-
tainment you proposed to yourselves from the elo-
quence of that learned member, Mr. Charles
Thompson, whom your suffrages appointed to this
honour after the delivery of the last anniversary
oration. Unhappily for the interests of science, his
want of health has not permitted him to comply
with your appointment. I beg, therefore, that
you would forget, for a while, the abilities ne-
cessary to execute this task with propriety, and
listen with candour to the efforts of a member,
whose attachment to the society was the only qua-

* This Inquiry was the subject of an Anniversary Ora-
tion. The style of an oration is therefore preserved in many-
parts of it.

4 NATURAL HISTORY OF MEDICINE

lification that entitled him to the honour of your
choice.

The subject I have chosen for this evening's
entertainment, is " An inquiry into the natural
" history of medicine among the Indians in North-
" America, and a comparative view of their "dis-
" eases and remedies, with those of civilized na-
" tions." You will readily anticipate the diffi-
culty of doing justice to this subject. How shall
we distinguish between the original diseases of the
Indians and those contracted from their inter-
course with the Europeans? By what arts shall
we persuade them to discover their remedies?
And lastly, how shall we come at the knowledge
of facts in that cloud of errors, in which the cre-
dulity of the Europeans, and the superstition of the
Indians, have involved both their diseases and re-
medies? These difficulties serve to increase the
importance of our subject. If I should not be
able to solve them, perhaps I may lead the way to
more successful endeavours for that purpose.

I shall first limit the tribes of Indians who are
to be the objects of this inquiry, to those who in-
habit that part of North- America which extends
from the 30th to the 60th degree of latitude.
When we exclude the Esquimaux, who inhabit

AMONG THE INDIANS. 5

the shores of Hudson's bay, we shall find a general
resemblance in the colour, manners, and state of
society, among all the tribes of Indians who inha-
bit the extensive tract of country above-mentioned.

Civilians have divided nations into savage, bar-
barous, and civilized. The savage live by fishing
and hunting; the barbarous, by pasturage or cattle;
and the civilized, by agriculture. Each of these
is connected together in such a manner, that the
whole appear to form different parts of a circle.
Even the manners of the most civilized nations
partake of those of the savage. It would seem as
if liberty and indolence were the highest pursuits
of man; and these are enjoyed in their greatest
perfection by savages, or in the practice of cus-
toms which resemble those of savages.

The Indians of North- America partake chiefly
of the manner of savages. In the earliest accounts
we have of them, we find them cultivating a spot
of ground. The maize is an original grain among
them. The different dishes of it which are in use
among the white people still retain Indian names.

It will be unnecessary to show that the Indians
live in a state of society adapted to all the exigen-
cies of their mode of life. Those who look for

6 NATURAL HISTORY OF MEDICINE

the simplicity and perfection of the state of nature,
must seek it in systems, as absurd in philosophy,
as they are delightful in poetry.

Before we attempt to ascertain the number or
history of the diseases of the Indians, it will be ne-
cessary to inquire into those customs among them
which we know influence diseases. For this pur-
pose I shall,

First, Mention a few facts which relate to the
birth and treatment of their children.

Secondly, I shall speak of their diet.

Thirdly, Of the customs which are peculiar to
the sexes, and,

Fourthly, Of those customs which are common
to them both*.

* Many of the facts contained in the Natural History of
Medicine among the Indians in this Inquiry, are taken from
La Hontan and Charlevoix's histories of Canada; but the
most material of them are taken from persons who had
lived or travelled among the Indians. The author acknow-
ledges himself indebted in a particular manner to Mr. Ed-
ward Hand, surgeon in the 18th regiment, afterwards
brigadier-general in the army of the United States, who*

AMONG THE INDIANS, 7

I. Of the birth and treatment of their children.

Much of the future health of the body depends
upon its original stamina. A child born of healthy-
parents always brings into the world a system
formed by nature to resist the causes of diseases.
The treatment of children among the Indians,
tends to secure this hereditary firmness of consti-
tution. Their first food is their mother's milk.
To harden them against the action of heat and
cold (the natural enemies of health and life among
the Indians) they are plunged every day into cold
water. In order to facilitate their being moved
from place to place, and at the same time to pre-
serve their shape, they are tied to a board, where
they lie on their backs for six, ten, or eighteen
months. A child generally sucks its mother till
it is two years old, and sometimes longer. It is
easy to conceive how much vigour their bodies
must acquire from this simple, but wholesome nou-
rishment. The appetite we sometimes observe in
children for flesh is altogether artificial. The pe-
culiar irritability of the system in infancy forbids
stimulating aliment of all kinds. Nature never
calls for animal food till she has provided the child

during several years' residence at Fort Pitt, directed his in-
quiries into their customs, diseases, and remedies, with a
success that does equal honour to his ingenuity and diligence.

8 NATURAL HISTORY OF MEDICINE

with those teeth which are necessary to divide it.
I shall not undertake to determine how far the
wholesome quality of the mother's milk is increased
by her refusing the embraces of her husband, du-
ring the time of giving suck,

II. The diet of the Indians is of a mixed nature,
being partly animal and partly vegetable. Their
animals are wild, and therefore easy of digestion.
As the Indians are naturally more disposed to the
indolent employment of fishing than hunting, in
summer, so we find them living more upon fish
than land animals, in that season of the year. —
Their vegetables consist of roots and fruits, mild
in themselves, or capable of being made so by the
action of fire. Although the interior parts of our
continent abound with salt springs, yet I cannot
find that the Indians used salt in their diet, till they
were instructed to do so by the Europeans. The
small quantity of fixed alkali contained in the ashes
on which they roasted their meat, could not add
much to its stimulating quality. They preserve
their meat from putrefaction, by cutting it into
small pieces, and exposing it in summer to the sun,
and in winter to the frost. In the one case its
moisture is dissipated, and in the other so frozen,
that it cannot undergo the putrefactive process. In
dressing their meat, they are careful to preserve

AMONG THE INDIANS. 9

its juices. They generally prefer it in the form of
soups. Hence we find, that among them the use
of the spoon, preceded that of the knife and fork.
They take the same pains to preserve the juice of
their meat when they roast it, by turning it often.
The efficacy of this animal juice, in dissolving meat
in the stomach, has not been equalled by any of
those sauces or liquors which modern luxury has
mixed with it for that purpose.

The Indians have no set time for eating, but
obey the gentle appetites of nature as often as they
are called by them. After whole days spent in
the chace or in war, they often commit those ex-
cesses in eating, to which long abstinence cannot
fail of prompting them. It is common to see them
spend three or four hours in satisfying their hun-
ger. This is occasioned not more by the quan-
tity they eat, than by the pains they take in masti-
cating it. They carefully avoid drinking water in
their marches, from an opinion that it lessens their
ability to bear fatigue.

III. We now come to speak of those customs
which are peculiar to the sexes. And, first, of
those which belong to the women. They are
doomed by their husbands to such domestic labour
as gives a firmness to their bodies, bordering upon

VOL. I. B

10 NATURAL HISTORY OF MEDICINE

the masculine. Their menses seldom begin to flow
before they are eighteen or twenty years of age,
and generally cease before they are forty. They
have them in small quantities, but at regular in-
tervals. They seldom marry till they are about
twenty. The constitution has now acquired a
vigour, which enables it the better to support the
convulsions of child-bearing. This custom like-
wise guards against a premature old age. Doctor
Bancroft ascribes the haggard looks, the loose
hanging breasts, and the prominent bellies of the
Indian women at Guiana, entirely to their bear-
ing children too early*. Where marriages are
unfruitful (which is seldom the case) a separation
is obtained by means of an easy divorce ; so that
they are unacquainted with the disquietudes which
sometimes arise from barrenness. During preg-
nancy, the women are exempted from the more
laborious parts of their duty: hence miscarriages
rarely happen among them. Nature is their only
midwife. Their labours are short, and accompa-
nied with little pain. Each woman is delivered
in a private cabin, without so much as one of her
own sex to attend her. After washing herself
in cold water, she returns in a few days to her
usual employments; so that she knows nothing of

* Natural History of Guiana.

AMONG THE INDIANS. 11

those accidents which proceed from the careless-
ness or ill management of midwives; or those
weaknesses which arise from a month's confine-
ment in a warm room. It is remarkable that there
is hardly a period in the interval between the erup-
tion and the ceasing of the menses, in which they
are not pregnant, or giving suck. This is the most
natural state of the constitution during that in-
terval ; and hence we often find it connected with
the best state of health, in the women of civilized
nations.

The customs peculiar to the Indian men, con-
sist chiefly in those employments which are neces-
sary to preserve animal life, and to defend their
nation. These employments are hunting and war,
each of which is conducted in a manner that tends
to call forth every fibre into exercise, and to en-
sure them the possession of the utmost possible
health. In times of plenty and peace, we see them
sometimes rising from their beloved indolence, and
shaking off its influence by the salutary exercises
of dancing and swimming. The Indian men sel-
dom marry before they are thirty years of age:
they no doubt derive considerable vigour from
this custom ; for while they are secured by it from
the enervating effects of the premature dalliance of
love, they may insure more certain fruitfulness to

12 NATURAL HISTORY OF MEDICINE

their wives, and entail more certain health upon
their children. Tacitus describes the same cus-
tom among the Germans, and attributes to it the
same good effects. " Sera juvenum venus, eoque
" inexhausta pubertas; nee virgines festinantur;
" eadem juventa, similis proceritas, pares vali*
" dique miscentur; ac robora parentum liberi
" referunt*."

Among the Indian men, it is deemed a mark of
heroism to bear the most exquisite pain without
complaining ; upon this account they early inure
themselves to burning part of their bodies with
fire, or cutting them with sharp instruments. No
young man can be admitted to the honours of man-
hood or war, who has not acquitted himself well in
these trials of patience and fortitude. It is easy to
conceive how much this contributes to give a tone
to the nervous system, which renders it less sub-
ject to the occasional causes of diseases.

IV. We come now to speak of those customs
which are common to both sexes : these are

* Caesar, in his history of the Gallic war, gives the same
account of the ancient Germans. His words are a Qui
" diutissimi impuberes permanserunt, maximam inter suos
" ferunt laudem : hoc ali staturam, ali vires, nervasque con-
" firmari putant." Lib. vi. xxi.

AMONG THE INDIANS. 13

painting, and the use of the cold bath. The
practice of anointing the body with oil is common
to the savages of all countries ; in warm climates
it is said to promote longevity, by checking ex-
cessive perspiration. The Indians generally use
bear's grease mixed with a clay, which bears the
greatest resemblance to the colour of their skins.
This pigment serves to lessen the sensibility of the
extremities of the nerves ; it moreover fortifies
them against the action of those exhalations, which
we shall mention hereafter, as a considerable source
of their diseases. The cold bath likewise forti-
fies the body, and renders it less subject to those
diseases which arise from the extremes and vicissi-
tudes of heat and cold. We shall speak hereafter
of the Indian manner of using it.

»

It is a practice among the Indians never to
drink before dinner, when they work or travel.
Experience teaches, that filling the stomach with
cold water in the forenoon, weakens the appetite,
and makes the system more sensible of heat and
fatigue.

The state of society among the Indians excludes
the influence of most of those passions which dis-
order the body. The turbulent effects of anger
are concealed in deep and lasting resentments.

14 NATURAL HISTORY OF MEDICINE

Envy and ambition are excluded by their equality
of power and property. Nor is it necessary that
the perfections of the whole sex should be ascribed
to one, to induce them to marry. " The weak-
" ness of love (says Dr. Adam Smith) which is so
" much indulged in ages of humanity and polite-
" ness, is regarded among savages as the most
" unpardonable effeminacy. A young man wTould
" think himself disgraced for ever, if he showed
" the least preference of one woman above another,
" or did not express the most complete indiffe-
" rence, both about the time when, and the person
" to whom, he was to be married*." Thus are
they exempted from those violent or lasting dis-
eases, which accompany the several stages of such
passions in both sexes among civilized nations.

It is remarkable that there are no deformed In-
dians. Some have suspected, from this circum-
stance, that they put their deformed children to
death ; but nature here acts the part of an unnatu-
ral mother. The severity of the Indian manners
destroy themf .

* Theory of Moral Sentiments.

t Since the intercourse of the white people with the In-
dians, we find some of them deformed in their limbs. This
deformity, upon inquiry, appears to be produced by those

AMONG THE INDIANS. 15

From a review of the customs of the Indians,
we need not be surprised at the stateliness, regula-
rity of features, and dignity of aspect by which
they are characterized. Where we observe these
among ourselves, there is always a presumption of
their being accompanied with health, and a strong
constitution. The circulation of the blood is more
languid in the Indians, than in persons who are in
the constant exercise of the habits of civilized life.
Out of eight Indian men whose pulses I once ex-
amined at the wrists, I did not meet with one in
whom the artery beat more than sixty strokes in a
minute.

The marks of old age appear more early among
Indian, than among civilized nations.

Having finished our inquiry into the physical
customs of the Indians, we shall now proceed to
inquire into their diseases,

A celebrated professor of anatomy has asserted,
that we could not tell, by reasoning a priori, that
the body was mortal, so intimately woven with its
texture are the principles of life. Lord Bacon
declares, that the onlv cause of death which is na-

' ml

accidents, quarrels, &c which have been introduced among
them by spiritous liquors.

16 NATURAL HISTORY OF MEDICINE

tural to man, is that from old age ; and complains
of the imperfection of physic, in not being able to
guard the principle of life, until the whole of the
oil that feeds it is consumed. We cannot as yet
admit this proposition of our noble philosopher. In
the inventory of the grave in every country, we
find more of the spoils of youth and manhood than
of a#e. This must be attributed to moral as well

o

as physical causes.

We need only recollect the custom among the
Indians, of sleeping in the open air in a variable
climate ; the alternate action of heat and cold upon
their bodies, to which the warmth of their cabins
exposes them ; their long marches ; their exces-
sive exercise ; their intemperance in eating, to
which their long fasting and their public feasts
naturally prompt them ; and, lastly, the vicinity
of their habitations to the banks of rivers, in or-
der to discover the empire of diseases among them
in every stage of their lives. They have in vain
attempted to elude the general laws of mortality,
while their mode of life subjects them to these re-
mote, but certain causes of diseases.

From what we know of the action of these pow-
ers upon the human body, it will hardly be neces-
sary to appeal to facts to determine that fevers

AMONG THE INDIANS. 17

t

constitute the only diseases among the Indians.
These fevers are occasioned by the insensible quali-
ties of the air. Those which are produced by cold
and heat are of the inflammatory kind, such as pleu-
risies, peripneumonies, and rheumatisms. Those
which are produced by the insensible qualities of
the air, or by putrid exhalations, are intermitting,
remitting, inflammatory, and malignant, according
as the exhalations are combined with more or less
heat or cold. The dysentery (which is an In-
dian disease) comes under the class of fevers. It
appears to be the febris intro versa of Dr. Sydenham.

The Indians are subject to animal and vege-
table poisons. The effects of these upon the
body, are in some degree analogous to the exhala-
tions we have mentioned. When they do not
bring on sudden death, they produce, according to
their force, either a common inflammatory, or a
malignant fever.

The small pox and the venereal disease
were communicated to the Indians of North- Ame-
rica by the Europeans. Nor can I find that they
were ever subject to the scurvy. Whether this
was obviated by their method of preserving their
flesh, or by their mixing it at all times with vege-
tables, I shall not undertake to determine. Their
vol. i, c

18 NATlTRAL HISTORY OF MEDICINE

peculiar customs and manners seem to have ex-
empted them from this, as well as from the com-
mon diseases of the skin.

I have heard of two or three cases of the gout
among the Indians, but it was only among those
who. had learned the use of rum from the white
people. A question naturally occurs here, and
that is, why does not the gout appear more fre-
quently among thai class of people, who consume
the greatest quantity of rum among ourselves?
To this I answer, that the effects of this liquor
upon those enfeebled people, are too sudden and
violent, to admit of their being thrown upon the
extremities ; as we know them to be among the
Indians. They appear only in visceral obstruc-
tions, and a complicated train of chronic diseases.
Thus putrid miasmata are sometimes too strong to
bring on a fever, but produce instant debility and
death. The gout is seldom heard of in Russia,
Denmark, or Poland. Is this occasioned by the
vigour of constitution peculiar to the inhabitants of
those northern countries ? or is it caused by their
excessive use of spirituous liquors, which produce
the same chronic complaints among them, which
we said were common among the lower class of
people in this country ? The similarity of their
diseases makes the last of these suppositions the

AMONG THE INDIANS. 19

most probable. The effects of wine, like tyranny
in a well formed government, are felt first in the
extremities ; while spirits, like a bold invader,
seize at once upon the vitals of the constitution.

After much inquiry, I have not been able to find
a single instance of fatuity among the Indians,
and but few instances of melancholy and mad-
ness ; nor can I find any accounts of diseases
from worms among them. Worms are common
to most animals ; they produce diseases only in
weak, or increase them in strong constitutions*.
Hence they have no place in the nosological sys-
tems of physic. Nor is dentition accompanied
by disease among the Indians. The facility with
which the healthy children of healthy parents cut
their teeth among civilized nations, gives us reason
to conclude that the Indian children never suffer
from this quarter.

The Indians appear moreover to be strangers to
diseases and pains in the teeth.

* Indian children are not exempted from worms. It is
common with the Indians, when a fever in their children is
ascribed by the white people to worms (from their being
discharged occasionally in their stools), to say, " the fever
" makes the worms come, and not the worms the fever,"

20 NATURAL HISTORY OF MEDICINE

The employments of the Indians subject them
to many accidents ; hence we sometimes read of
wounds, fractures, and luxations among
them.

Having thus pointed out the natural diseases of
the Indians, and shown what diseases are foreign
to them, we may venture to conclude, that fe-
vers, old age, casualties, and war are the
only natural outlets of human life. War is no-
thing but a disease ; it is founded in the imper-
fection of political bodies, just as fevers are found-
ed on the weakness of the animal body. Provi-
dence in these diseases seems to act like a mild le-
gislature, which mitigates the severity of death, by
inflicting it in a manner the least painful, upon the
whole, to the patient and the survivors.

Let us now inquire into the remedies of the
Indians. These, like their diseases, are simple,
and few in number. Among the first of them we
shall mention the powers of nature. Fevers,
we said formerly, constituted the chief of the dis-
eases among the Indians ; they are likewise, in the
hands of nature, the principal instruments to re-
move the evils which threaten her dissolution ; but
the event of these efforts of nature, no doubt,
soon convinced the Indians of the danger of trust-

AMONG THE INDIANS. 21

ing her in all cases ; and hence, in the earliest ac-
counts we have of their manners, we read of per-
sons who were intrusted with the office of phy*
sicians.

It will be difficult to find out the exact order in
which the Indian remedies were suggested by na-
ture or discovered by art ; nor will it be easy to
arrange them in proper order. I shall, however,
attempt it, by reducing them to natural and

ARTIFICIAL.

To the class of natural remedies belongs
the Indian practice of abstracting from their pa-
tients all kinds of stimulating aliment. The com-
pliance of the Indians with the dictates of nature,
in the early stage of a disease, no doubt, prevents,
in many cases, their being obliged to use any
other remedy. They follow nature still closer, in
allowing their patients to drink plentifully of cold
water ; this being the only liquor a patient calls for
in a fever.

Sweating is likewise a natural remedy. It was
probably suggested by observing fevers to be ter-
minated by it. I shall not inquire how far these
sweats are essential to the crisis of a fever. The
Indian mode of procuring this evacuation is as fol-

22 NATURAL HISTORY OF MEDICINE

lows : the patient is confined in a close tent, or
wigwam, over a hole in the earth, in which a red
hot stone is placed ; a quantity of water is thrown
upon this stone, which instantly involves the pa-
tient in a cloud of vapour and sweat ; in this situ-
ation he rushes out, and plunges himself into a ri-
ver, from Whence he retires to his bed. If the
remedy has been used with success, he rises from
his bed in four and twenty hours, perfectly reco-
vered from his indisposition. This remedy is used
not only to cure fevers, but remove that uneasiness
which arises from fatigue of body.

A third natural remedy among the Indians, is
purging. The fruits of the earth, the flesh of
birds, and other animals feeding upon particular
vegetables, and, above all, the spontaneous efforts
of nature, early led the Indians to perceive the ne-
cessity and advantages of this evacuation.

Vomits constitute their fourth natural remedy.
They were probably, like the former, suggested
by nature, and accident. The ipecacuanha is one
of the many roots they employ for that purpose.

The artificial remedies made use of by
the Indians, are bleeding, caustics, and as-
tringent medicines. They confine bleeding

AMON,G THE INDIANS. 23

entirely to the part affected. To know that open-
ing a vein in the arm, or foot, would relieve a pain
in the head or side, supposes some knowledge of
the animal economy, and therefore marks an ad-
vanced period in the history of medicine.

Sharp stones and thorns are the instruments they
use to procure a discharge of blood.

We have an account of the Indians using some-
thing like a potential caustic, in obstinate
pains. It consists of a piece of rotten wood called
punk, which they place upon the part affected, and
afterwards set it on fire : the fire gradually con-
sumes the wood, and1 its ashes burn a hole in the
flesh.

The undue efforts of nature, in those fevers
which are connected with a diarrhoea, or dysen-
tery, together with those hemorrhages to which
their mode of life exposed them, necessarily led
them to an early discovery of some astringent
vegetables. I am uncertain whether the In-
dians rely upon astringent, or any other vegeta-
bles, for the cure of the intermitting fever. This
disease among them probably requires no other
remedies than the cold bath, or cold air. Its
greater obstinacy, as well as frequency, among

24 natural history of medicine

ourselves, must be sought for in the greater fee-
bleness of our constitutions, and in that change
which our country has undergone, from meadows,
mill-dams, and the cutting down of woods ; where-
by morbid exhalations have been multiplied, and
their passage rendered more free, through every
part of country.

This is a short account of the remedies of the
Indians. If they are simple, they are like their
eloquence, full of strength ; if they are few in
number, they are accommodated, as their lan-
guages are to their ideas, to the whole of their
diseases.

We said, formerly, that the Indians were sub-
ject to accidents, such as wounds, fractures, and
the like. In these cases, nature performs the of-
fice of a surgeon. We may judge of her qualifi-
cations for this office, by observing the marks of
wounds and fractures, which are sometimes dis-
covered on wild animals. But further, what is the
practice of our modern surgeons in these cases ?
Is it not to lay aside plasters and ointments, and
trust the whole to nature? Those ulcers which re-
quire the assistance of mercury, bark, and a par-
ticular regimen are unknown to the Indians.

AMONG THE INDIANS. 25

The hemorrhages which sometimes follow
their wounds, are restrained by plunging them-
selves into cold water, and thereby producing a
constriction upon the bleeding vessels.

Their practice of attempting to recover drown-
ed people, is irrational and unsuccessful. It con-
sists in suspending the patient by the heels, in or-
der that the water may flow from his mouth.
This practice is founded on a belief that the pa-
tient dies from swallowing an excessive quantity
of water. But modern observations teach us that
drowned people die from another cause. This
discovery has suggested a method of cure, directly
opposite to that in use among the Indians ; and has
shown us that the practice of suspending by the
heels is hurtful.

I do not find that the Indians ever suffer in their
limbs from the action of c old upon them. Their
mokasons*, by allowing their feet to move freely,
and thereby promoting the circulation of the
blood, defend their lower extremities in the day-
time, and their practice of sleeping with their feet
near a fire, defends them from the morbid effects
of cold at night. In those cases where the motion

* Indian shoes.
VOL. I. D

26 NATURAL HISTORY OF MEDICINE

of their feet in their mokasons is not sufficient to
keep them warm, they break the ice, and restore
their warmth by exposing them for a short time
to the action of cold water*.

We have heard much of their specific antidotes
to the venereal disease. In the accounts of
these anti-venereal medicines, some abatement
should be made for that love of the marvellous,
and of novelty, which are apt to creep into the
writings of travellers and physicians. How many
medicines which were once thought infallible in
this disease, are now rejected from the materia
medica ! I have found upon inquiry that the In-
dians always assist their medicines in this disease,
by a regimen which promotes perspiration. Should
we allow that mercury acts as a specific in destroy-
ing this disease, it does not follow that it is proof
against the efficacv of medicines which act more
mechanically upon the bodyf .

* It was remarked in Canada, in the winter of the year
1759, during- the war before last, that none of those soldiers
who wore mokasons were frost-bitten, while few of those
escaped that were much exposed to the cold who wore shoes.

f I cannot help suspecting the anti-venereal qualities of
the lobelia, ceanothus and ranunculus, spoken of by Mr.
Kalm, in the Memoirs of the Swedish Academy. Mr. Hand
informed me, that the Indians rely chiefly upon a plentiful

AMONG THE INDIANS. 27

There cannot be a stronger mark of the imper-
fect state of knowledge in medicine among the In-
dians, than their method of treating the small-
pox. We are told that they plunge themselves
in cold water in the beginning of the disease, and
that it often proves fatal to them.

Travellers speak in high terms of the Indian
antidotes to poisons. We must remember
that many things have been thought poisonous,
which later experience hath proved to possess no
unwholesome quality. Moreover, the uncertainty
and variety in the operation of poisons, renders it
extremely difficult to fix the certainty of the anti-
dotes to them. Hoav many specifics have derived
their credit for preventing the hydrophobia, from
persons being wounded by animals, who were not
in a situation to produce that disease ! If we may
judge of all the Indian antidotes to poisons, by
those which have fallen into our hands, we have
little reason to ascribe much to them in any cases
whatever.

#

I have heard of their performing several remark-
able cures upon stiff joints, by an infusion of

use of the decoctions of the pine-trees for the cure of the
venereal disease. He added, moreover, that he had often
known this disease prove fatal to them.

28 NATURAL HISTORY OF MEDICINE

certain herbs in water. The mixture of several
herbs together in this infusion calls in question the
specific efficacy of each of them. I cannot help
attributing the whole success of this remedy to the
great heat of the water in which the herbs were
boiled, and to its being applied for a long time to
the part affected. We find the same medicine to
vary frequently in its success, according to its
strength, or to the continuance of its application.
De Haen attributes the good effects of electricity,
entirely to its being used for several months.

I have met with one case upon record of their
aiding nature in parturition. Captain Carver
gives us an account of an Indian woman in a diffi-
cult labour, being suddenly delivered in conse-
quence of a general convulsion induced upon her
system, by stopping, for a short time, her mouth
and nose, so as to obstruct her breathing.

We are sometimes amused with accounts of In-
dian remedies for the dropsy, epilepsy, colic,
gravel, and gout. . If, with all the advantages
which modern physicians derive from their know-
ledge in anatomy, chemistry, botany, and phi-
losophy ; if, with the benefit of discoveries
communicated from abroad, as well as handed
down from our ancestors, by more certain me-

AMONG THE INDIANS. 29

thods than tradition, we are still ignorant of cer-
tain remedies for these diseases ; what can we ex-
pect from the Indians, who are not only deprived
of these advantages, but want our chief motive,
the sense of the pain and danger of those diseases,
to prompt them to seek for such remedies to re-
lieve them? There cannot be a stronger proof
of their ignorance of proper remedies for new or
difficult diseases, than their having recourse to en-
chantment. But to be more particular; I have
taken pains to inquire into the success of some of
these Indian specifics, and have never heard of
one well attested case of their efficacy. I believe
they derive all their credit from our being igno-
rant of their composition. The influence of se-
crecy is well known in establishing the credit of
a medicine. The sal seignette was supposed to be
an infallible medicine for the intermitting fever,
while the manufactory of it was confined to an apo-
thecary at Rochelle ; but it lost its virtues as soon
as it was found to be composed of the acid of tar-
tar and the fossil alkali. Dr. Ward's famous pill
and drop ceased to do wonders in scrophulous
cases, as soon as he bequeathed to the world his
receipts for making them.

I foresee an objection to what has been said con-
cerning the remedies of the Indians, drawn from

30 NATURAL HISTORY OF MEDICINE

that knowledge which experience gives to a mind
intent upon one subject. We have heard much
of the perfection of their senses of seeing and hear-
ing. An Indian, we are told, will discover not
only a particular tribe of Indians by their foot-
steps, but the distance of time in which they were
made. In those branches of knowledge which
relate to hunting and war, the Indians have ac-
quired a degree of perfection that has not been
equalled by civilized nations. But we must re-
member, that medicine among them does not pos-
sess the like advantages with the arts of war and
hunting, of being the chief object of their atten-
tion. The physician and the warrior are united
in one character ; to render him as able in the for-
mer as he is in the latter profession, would require
an entire abstraction from every other employ-
ment, and a familiarity with external objects,
which are incompatible with the wandering life of
savages.

Thus have we finished our inquiry into the dis-
eases and remedies of the Indians in North- Ame-
rica. We come now to inquire into the diseases
and remedies of civilized nations.

Nations differ in their degrees of civilization.
We shall select one for the subject of our inquiries

AMONG THE INDIANS. 31

which is most familiar to us ; I mean the British
nation. Here we behold subordination and classes
of mankind established by government, commerce,
manufactures, and certain customs common to
most of the civilized nations of Europe. We
shall trace the origin of their diseases through their
customs, in the same manner as we did those of
the Indians.

I. It will be sufficient to name the degrees of
heat, the improper aliment, the tight dresses, and
the premature studies children are exposed to, in
order to show the ample scope for diseases, which
is added to the original defect of stamina they de-
rive from their ancestors.

II. Civilization rises in its demands upon the
health of women. Their fashions ; their dress and
diet ; their eager pursuits and ardent enjoyment of
pleasure; their indolence and undue evacuations
in pregnancy ; their cordials, hot regimen, and
neglect, or use of art, in child-birth, are all so many
inlets to disease.

Humanity would fain be silent, while philoso-
phy calls upon us to mention the effects of inte-
rested marriages, and of disappointments in love,
increased by that concealment which the tyranny

32 NATURAL HISTORY OF MEDICINE

of custom has imposed upon the sex*. Each of
these exaggerates the natural, and increases the
number of artificial diseases among women.

III. The diseases introduced by civilization ex-
tend themselves through every class and profession
among men. How fatal are the effects of idleness
and intemperance among the rich, and of hard la-
bour and penury among the poor! What pallid
looks are contracted by the votaries of science
from hanging over the " sickly taper!" How
many diseases are entailed upon manufacturers, by
the materials in which they work, and the posture
of their bodies! What monkish diseases do we
observe from monkish continence and monkish
vices ! We pass over the increase of accidents
from building, sailing, riding, and the like. War,
as if too slow in destroying the human species,

* " Married women are more healthy and long-lived
" than single women. The registers, examined by Mr. Mu-
" ret, confirm this observation ; and show particularly, that
** of equal numbers of single and married women between
" fifteen and twenty-five years of age, more of the former
" died than of the latter, in the proportion of two to one :
" the consequence, therefore, of following nature must be
" favourable to health among the female sex." Supple-
ment to Price's Observations on Reversionary Payments,
p. 357.

AMONG THE INDIANS. 33

calls in a train of diseases peculiar to civilized na-
tions. What havoc have the corruption and
monopoly of provisions, a damp soil, and an un-
wholesome sky, made, in a few days, in an army !
The achievements of British valour, at the Ha-
vannah, in the last war, were obtained at the ex-
pence of 9,000 men, 7,000 of whom perished
with the West- India fever*. Even our modern
discoveries in geography, by extending the empire
of commerce, have likewise extended the empire
of diseases. What desolation have the East and
West- Indies made of British subjects ! It has been
found, upon a nice calculation, than only ten of a
hundred Europeans, live above seven years after
they arrive in the island of Jamaica.

* The modern writers upon the diseases of armies, won-
der that the Greek and Roman physicians have left us
nothing upon that subject. But may not most of the dis-
eases of armies be produced by the different manner in
which wars are carried on by the modern nations ? The
discoveries in geography, by extending the field of war,
expose soldiers to many diseases from long voyages, and
a sudden change of climate, which were unknown to the
armies of former ages. Moreover, the form of the wea-
pons, and the variety in the military exercises of the Gre-
cian and Roman armies, gave a vigour to the constitution,
which can never be acquired by the use of muskets and
artillery.

VOL. I. E

s

34 NATURAL HISTORY OF MEDICINE

IV. It would take up too much of our time to
point out all the customs, both physical and moral,
which influence diseases among both sexes. The
former have engendered the seeds of diseases in
the human body itself: hence the origin of ca-
tarrhs, jail and miliary fevers, with a long train
of other diseases, which compose so great a
part of our books of medicine. The latter like-
wise have a large share in producing diseases. I
am not one of those modern philosophers, who
derive the vices of mankind from the influence of
civilization ; but I am safe in asserting, that their
number and malignity increase with the refine-
ments of polished life. To prove this, we need
only survey a scene too familiar to affect us : it is
a bedlam ; which injustice, inhumanity, avarice,
pride, vanity, and ambition, have filled with inha-
bitants.

Thus have I briefly pointed out the customs
which influence the diseases of civilized nations.
It remains now that we take notice of their dis-
eases. Without naming the many new fevers,
fluxes, hemorrhages, swellings from water, wind,
flesh, fat, pus, and blood ; foulnesses on the skin,
from cancers, leprosy, yawes, poxes, and itch;
and, lastly, the gout, the hysteria, and the hypo-
condriasis, in all their variety of known and un-

AMONG THE INDIANS. 35

known shapes ; I shall sum up all that is necessary
upon this subject, by adding, that the number of
diseases which belong to civilized nations, accord-
ing to Doctor Cullen's nosology, amounts to
1387 ; the single class of nervous diseases form
612 of this number.

Before we proceed to speak of the remedies of
civilized nations, we shall examine into the abi-
lities of nature in curing their diseases. We
found her active and successful in curing the dis-
eases of the Indians. Are her strength, wisdom,
or benignity, equal to the increase of those dangers
which threaten her dissolution among civilized na-
tions? In order to answer this question, it will
be necessary to explain the meaning of the term
nature.

By nature, in the present case, I understand
nothing but physical necessity. This at once ex-
cludes every thing like intelligence from her ope-
rations : these are all performed in obedience to
the same laws which govern vegetation in plants,
and the intestine motions of fossils. They are as
truly mechanical as the laws of gravitation, elec-
tricity, or magnetism. A ship when laid on her
broadside by a wave, or a sudden blast of wind,
rises by the simple laws of her mechanism ; but

36 NATURAL HISTORY OF MEDICINE

suppose this ship to be attacked by fire, or a wa-
ter-spout, we are not to call in question the skill
of the ship-builder, if she be consumed by the one,
or sunk by the other. In like manner, the Author
of nature hath furnished the body with powers to
preserve itself from its natural enemies ; but when
it is attacked by those civil foes which are bred
by the peculiar customs of civilization, it resem-
bles a company of Indians, armed with bows and
arrows, against the complicated and deadly ma-
chinery of fire-arms. To place this subject in a pro-
per light, I shall deliver a history of the opera-
tions of nature in a few of the diseases of civilized
nations.

I. There are cases in which nature is still suc-
cessful in curing diseases.

In fevers she still deprives us of our appetite for
animal food, and imparts to us a desire for cool
air and cold water.

In hemorrhages she produces a faintness, which
occasions a coagulum in the open vessels ; so that
the further passage of blood through them is ob-
structed.

AMONG THE INDIANS. 37

In wounds of the flesh and bones she discharges
foreign matter by exciting an inflammation, and
supplies the waste of both with new flesh and
bone.

II. There are cases where the efforts of nature
are too feeble to do service, as in malignant and
chronic fevers.

III. There are cases where the efforts of nature
are over proportioned to the strength of the dis-
ease, as in the cholera morbus and dysentery.

IV. There are cases where nature is idle, as in
the atonic stages of the gout, the cancer, the epi-
lepsy, the mania, the venereal disease, the apo-
plexy, and the tetanus*.

V. There are cases in which nature does mis-
chief. She wastes herself with an unnecessary
fever, in a dropsy and consumption. She throws
a plethora upon the brain and lungs in the apo-
plexy and peripneumonia notha. She ends a
pleurisy and peripneumony in a vomica, or em-
pyema. She creates an unnatural appetite for
food in the hypochondriac disease. And, lastly,

* Hoffman de hypothesium medicarum damno, sect. xv.

38 NATURAL HISTORY OF MEDICINE

she drives the melancholy patient to solitude,
where, by brooding over the subject of his insani-
ty, he increases his disease.

We are accustomed to hear of the salutary kind-
ness of nature in alarming us with pain, to prompt
us to seek for a remedy. But,

VI. There are cases in which she refuses to
send this harbinger of the evils which threaten
her, as in the aneurism, scirrhus, and stone in the
bladder.

VII. There are cases where the pain is not
proportioned to the danger, as in the tetanus, con-
sumption, and dropsy of the head. And,

VIII. There are cases where the pain is over-
proportioned to the danger, as in the paronychia
and tooth-ach.

This is a short account of the operations of na-
ture, in the diseases of civilized nations. A lu-
natic might as well plead against the sequestration
of his estate, because he once enjoyed the full ex-
ercise of his reason, or because he still had lucid
intervals, as nature be exempted from the charges
we have brought against hen

AMONG THE INDIANS. 39

But this subject will receive strength from con-
sidering the remedies of civilized nations. All
the products of the vegetable, fossil, and animal
kingdoms, tortured by heat and mixture into an
almost infinite variety of forms ; bleeding, cup-
ping, artificial drains by setons, issues, and blisters ;
exercise, active and passive; voyages and journies;
baths, warm and cold ; waters, saline, aerial, and
mineral; food by weight and measure; the royal
touch; enchantment; miracles; in a word, the
combined discoveries of natural history and philo-
sophy, united into a system of materia medica, all
show, that although physicians are in speculation
the servants, yet in practice they are the masters of
nature. The whole of their remedies seem con-
trived on purpose to arouse, assist, restrain, and
controuf her operations.

There are some truths like certain liquors,
which require strong heads to bear them. I feel
myself protected from the prejudices of vulgar
minds, when I reflect that I am delivering these
sentiments in a society of philosophers.

Let us now take a comparative view of the
diseases and remedies of the Indians with those of
civilized nations. We shall begin with their dis-
eases.

40 NATURAL HISTORY OF MEDICINE

In our account of the diseases of the Indians, we
beheld death executing his commission, it is true;
but then his dart was hid in a mantle, under which
he concealed his shape. But among civilized na-
tions we behold him multiplying his weapons in
proportion to the number of organs and functions
in the body ; and pointing each of them in such a
manner, as to render his messengers more terrible
than himself.

We said formerly that fevers constituted the
chief diseases of the Indians. According to Doc-
tor Sydenham's computation, above 66,000 out
of 100,000 died of fevers in London, about 100
years ago ; but fevers now constitute but a little
more than one-tenth part of the diseases of that
city. Out of 21,780 persons who died in London
between December, 1770, and December, 1771,
only 2273 died of simple fevers. I have more
than once heard Doctor Huck complain, that he
could find no marks of epidemic fevers in London,
as described by Dr. Sydenham. London has un-
dergone a revolution in its manners and customs
since Doctor Sydenham's time. New diseases, the
offspring of luxury, have supplanted fevers ; and
the few that are left are so complicated with other
diseases, that their connection can no longer be
discovered with an epidemic constitution of the

AMONG THE INDIANS. 41

year. The pleurisy and peripneumony, those in-
flammatory fevers of strong constitutions, are now
lost in catarrhs, or colds, which, instead of chal-
lenging the powers of nature or art to a fair com-
bat, insensibly undermine the constitution, and
bring on an incurable consumption. Out of 22,434
who died in London between December, 1769,
and the same month in 1770, 4594 perished with
that British disease. Our countryman, Doctor
Maclurg, has ventured to foretel that the gout will
be lost in a few years, in a train of hypocondriac,
hysteric, and bilious diseases. In like manner,
may we not look for a season when fevers, the na-
tural diseases of the human body, will be lost in
an inundation of artificial diseases, brought on by
the modish practices of civilization ?

It may not be improper to compare the prog-
nosis of the Indians, in diseases, with that of
civilized nations, before we take a comparative
view of their remedies.

The Indians are said to be successful in pre-
dicting the events of diseases. While diseases are
simple, the marks which distinguish them, or cha-
racterize their several stages, are generally uni-
form and obvious to the most indifferent observer.
These marks afford so much certainty, that the In-

VOL. I. f

42 NATURAL HISTORY OF MEDICINE

dians sometimes kill their physicians for a false
prognosis, charging the death of the patient to
their carelessness, or ignorance. They estimate
the danger of their patients by the degrees of
appetite; while an Indian is able to eat, he is
looked upon as free from danger. But when we
consider the number and variety in the signs of
diseases, among civilized nations, together with
the shortness of life, the fallacy of memory, and
the uncertainty of observation, where shall we find
a physician willing to risk his reputation, much less
his life, upon the prediction of the event of our
acute diseases? We can derive no advantage from
the simple sign, by which the Indians estimate
the danger of their patients; for we daily see a
want of appetite for food in diseases which are at-
tended with no danger; and we sometimes observe
an unusual degree of this appetite to precede the
agonies of death. I honour the name of Hip-
pocrates: but forgive me, ye votaries of anti-
quity, if I attempt to pluck a few grey hairs from
his venerable head. I was once an idolater at his
altar, nor did I turn apostate from his worship, till
I was taught, that not a tenth part of his prog-
nostics corresponded with modern experience, or
observation. The pulse*, urine, and sweats, from

* Doctor Cullen used to inform his pupils, that after forty
years' experience, he could find no relation between his own

AMONG THE INDIANS. 43

which the principal signs of life and death have
been taken, are so variable, in most of the acute
diseases of civilized nations, that the wisest phy-
sicians have in some measure excluded the prog-
nosis from being a part of their profession.

I am here insensibly led to make an apology for
the instability of the theories and practice of
physic. The theory of physic is founded upon
the laws of the animal economy. These (unlike
the laws of the mind, or the common laws of
matter) do not appear at once, but are gradually
brought to light by the phenomena of diseases.
The success of nature in curing the simple diseases
of Saxony, laid the foundation for the anima me-
dic a of Doctor Stahl. The endemics of Hol-
land* led Doctor Boerhaave to seek for the

observations on the pulse, and those made by Doctor Solano.
The climate and customs of the people in Spain being so
different from the climate and customs of the present inha-
bitants of Britain, may account for the diversity of their ob-
servations. Doctor Heberden's remarks upon the pulse, in
the second volume of the Medical Transactions, are calcu-
lated to show how little the issue of diseases can be learned
from it.

* " The scurvy is very frequent in Holland ; and draws
its origin partly from their strong food, sea-fish, and smoked

44 NATURAL HISTORY OF MEDICINE

causes of all diseases in the fluids. And the
universal prevalence of diseases of the nerves, in
Great-Britain, led Doctor Cullen to discover
their peculiar laws, and to found a system upon
them; a system, which will probably last till
some new diseases are let loose upon the human
species, which shall unfold other laws oi the ani-
mal economy.

It is in consequence of this fluctuation in the
principles and practice of physic, being so neces-
sarily connected with the changes in the customs
of civilized nations, that old and young physicians
so often disagree in their opinions and practices.
And it is by attending to the constant changes in
these customs of civilized nations, that those phy-
sicians have generally become the most eminent,
who have soonest emancipated themselves from
the tyranny of the schools of physic; and have
occasionally accommodated their principles and

flesh, and partly from their dense and moist air, together
with their bad water." Hoffman on Endemical Distempers.

" We are now in North-Holland ; and I have never seen,
among so few people, so many infected with the leprosy as
here. They say the reason is, because they eat so much
fish.'.' Howell's Familiar Letters.

AMONG THE INDIANS. 45

practice to the changes in diseases*. This variety
in diseases, which is produced by the changes in
the customs of civilized nations, will enable us to
account for many of the contradictions which are
to be found in authors of equal candour and abili-
ties, who have written upon the materia medica.

In forming a comparative view of the remedies
of the Indians, with those of civilized nations, we
shall remark, that the want of success in a medi-
cine is occasioned by one of the following causes :

First, our ignorance of the disease. Secondly,
an ignorance of a suitable remedy. Thirdly, a
want of efficacy in the remedy.

* We may learn from these observations, the great im-
propriety of those Egyptian laws which oblige physicians
to adopt, in all cases, the prescriptions which had been col-
lected, and approved of, by the physicians of former ages.
Every change in the customs of civilized nations, produces
a change in their diseases, which calls for a change in their
remedies. What havoc would plentiful bleeding, purging,
and small beer, formerly used with so much success by Dr.
Sydenham in the cure of fevers, now make upon the en-
feebled citizens of London ! The fevers of the same, and
of more southern latitudes, still admit of such antiphlogistic
remedies. In the room of these, bark, wine, and other cor-
dial medicines, are prescribed in London in almost every
kind of fe ver.

46 NATURAL HISTORY OF MEDICINE

Considering the violence of the diseases of the
Indians, it is probable their want of success is al-
ways occasioned by a want of efficacy in their me-
dicines. But the case is very different among the
civilized nations. Dissections daily convince us
of our ignorance of the seats of diseases, and cause
us to blush at our prescriptions. How often are
we disappointed in our expectation from the most
certain and powerful of our remedies, by the ne-
gligence or obstinacy of our patients ! What mis-
chief have we done under the belief of false facts
(if I may be allowed the expression) and false theo-
ries ! We have assisted in multiplying diseases.
We have done more — we have increased their
mortality.

I shall not pause to beg pardon of the faculty,
for acknowledging, in this public manner, the weak-
nesses of our profession. I am pursuing Truth,
and while I can keep my eye fixed upon my guide,
I am indifferent whether I am led, provided she is
my leader.

But further, the Indian submits to his disease,
without one fearful emotion from his doubtfulness
of its event ; and at last meets his fate without an
an anxious wish for futurity ; except it is of being
admitted to an " equal sky," where

AMONG THE INDIANS. 47

" His faithful dog shall bear him company.' '

But, among civilized nations, the influence of a
false religion in good, and of a true religion in bad
men, has converted even the fear of death into a
disease. It is this original distemper of the ima-
gination which renders the plague most fatal, upon
his first appearance in a country.

Under all these disadvantages in the state of me-
dicine, among civilized nations, do more in pro-
portion die of the diseases peculiar to them, than
of fevers, casualties, and old age, among the In-
dians ? If we take our account from the city of
London, we shall find this to be the case. Near
a twentieth part of its inhabitants perish one year
with another. Nor does the natural increase of
inhabitants supply this yearly waste. If we judge
from the bills of mortality, the city of London
contains fewer inhabitants, by several thousands,
than it did forty years ago. It appears from this
fact, and many others of a like nature, which
might be adduced, that although the difficulty of
supporting children, together with some peculiar
customs of the Indians, which we mentioned,
limit their number, yet they multiply faster, and
die in a smaller proportion than civilized nations,
under the circumstances we have described. The

48 NATURAL HISTORY OF MEDICINE

Indians, we are told, were numerous in this coun-
try, before the Europeans settled among them.
Travellers agree likewise in describing numbers of
both sexes who exhibited all the marks of extreme
old age. It is remarkable that age seldom impairs
the faculties of their minds.

The mortality peculiar to those Indian tribes
who have mingled with the white people, must be
ascribed to the extensive mischief of spiritous
liquors. When these have not acted, they have
suffered from having accommodated themselves too
suddenly to the European diet, dress, and manners.
It does not become us to pry too much into fu-
turity ; but if we may judge from the fate of the
original natives of Hispaniola, Jamaica, and the
provinces on the continent, we may venture to
foretel, that, in proportion as the white people
multiply, the Indians will diminish ; so that in a
few centuries they will probably be entirely extir-
pated*.

* Even the influence of christian principles has not been
able to put a stop to the mortality introduced among the
Indians, by their intercourse with the Europeans. Dr.
Cotton Mather, in a letter to sir William Ashurst, printed
in Boston, in the year 1705, says, " that about five years be-
fore there were about thirty Indian congregations in the
southern parts of the province of Massachusetts-Bay." The

AMONG THE INDIANS. 49

It may be said, that health among the Indians,
like msensibility to cold and hunger, is propor-
tioned to their need of it ; and that the less degrees,
or entire want of health, are no interruption to the
ordinary business of civilized life.

To obviate this supposition, we shall first attend
to the effects of a single disease in those people
who are the principal wheels in the machine of
civil society. Justice has stopt its current, victo-
ries have been lost, wars have been prolonged, and
embassies delayed, by the principal actors in these
departments of government being suddenly laid up
by a fit of the gout. How many offences are daily
committed against the rules of good breeding, by
the tedious histories of our diseases, which com-
pose so great a part of modern conversation ! What
sums of money have been lavished in foreign coun-

same author, in his history of New-England, says, " That
in the islands of Nantucket and Martha's Vineyard, there
were 3000 adult Indians, 1600 of whom professed the chris-
tian religion." At present there is but one Indian congre-
gation in the whole Massachusetts province.

It may serve to extend our knowledge of diseases, to re-
mark, that epidemics were often observed to prevail among
the Indians in Nantucket, without affecting the white people.

VOL. I. G

50 NATURAL HISTORY OF MEDICINE

tries in pursuit of health* ! Families have been
ruined by the unavoidable expences of medicines
and watering-places. In a word, the swarms of
beggars which infest so many of the European
countries, urge their petitions for charity chiefly
by arguments derived from real or counterfeit
diseases, which render them incapable of support-
ing themselvesf .

But may not civilization, while it abates the
violence of natural diseases, increase the lenity of
those that are artificial, in the same manner that it
lessens the strength of natural vices by multiplying
them ? To answer this question, it will only be ne-
cessary to ask another : Who should exchange the
heat, thirst, and uneasiness of a fever, for one fit of
the colic or stone ?

The history of the number, combination, and
fashions of the remedies we have given, may serve

* It is said, there are seldom less than 20,000 British sub-
jects in France and Italy ; one half of whom reside or travel
in those countries upon the account of their health.

t Templeman computes, that Scotland contains 1,500,000
inhabitants ; 100,000 of whom, according to Mr. Fletcher,
are supported at the public expence. The proportion of
poor people is much greater in England, Ireland, France,
and Italy.

AMONG THE INDIANS. 51

to humble the pride of philosophy ; and to con-
vince us, that with all the advantages of the whole
circle of sciences, we are still ignorant of antidotes
to many of the diseases of civilized nations. We
sometimes sooth our ignorance, by reproaching our
idleness in not investigating the remedies peculiar
to this country. We are taught to believe that
every herb that grows in our woods is possessed of
some medicinal virtue, and that Heaven would be
wanting in benignity, if our country did not pro-
duce remedies for all the different diseases of its
inhabitants. It would be arrogating too much to
suppose that man was the only creature in our
world for whom vegetables grow. The beasts,
birds, and insects, derive their sustenance either
directly or indirectly from them ; while many of
them were probably intended, from their variety in
figure, foliage, and colour, only to serve as orna-
ments for our globe. It would seem strange that
the Author of nature should furnish every spot of
ground with medicines adapted to the diseases of
its inhabitants, and at the same time deny it the
more necessary articles of food and clothing. I
know not whether Heaven has provided every
country with antidotes even to the natural diseases
of its inhabitants. The intermitting fever is com-
mon in almost every corner of the globe ; but a
sovereign remedy for it has been discovered only

52 NATURAL HISTORY OF MEDICINE

in South- America. The combination of bitter and
astringent substances, which serve as a succeda-
neum to the Peruvian bark, is as much a prepara-
tion of art, as calomel or tartar emetic. Societies
stand in need of each other as much as individuals ;
and the goodness of the Deity remains unimpeach-
ed when we suppose, that he intended medicines
to serve (with other articles) to promote that know-
ledge, humanity, and politeness among the inhabi-
tants of the earth, which have been so justly attri-
buted to commerce.

We have no discoveries in the materia medica
to hope for from the Indians in North- America. It
would be a reproach to our schools of physic, if
modern physicians were not more successful than
the Indians, even in the treatment of their own
diseases.

Do the blessings of civilization compensate for
the sacrifice we make of natural health, as well as
of natural liberty ? This question must be answer-
ed under some limitations. When natural liberty
is given up for laws which enslave instead of pro-
tecting us, we are immense losers by the exchange.
Thus, if we arm the whole elements against our
health, and render every pore in the body an ave-

AMONG THE INDIANS. 53

nue for a disease, we pay too high a price for the
blessings of civilization.

In governments which have departed entirely
from their simplicity, partial evils are to be cured
by nothing but an entire renovation of their consti-
tution. Let the world bear with the professions
of law, physic, and divinity ; and let the lawyer,
physician, and divine yet learn to bear with each
other. They are all necessary, in the present state
of society. In like manner, let the woman of
fashion forget the delicacy of her sex, and submit
to be delivered bv a man-midwife*. Let her snatch
her offspring from her breast, and send it to repair
the weakness of its stamina, with the milk of a
ruddy cottagerf. Let art supply the place of nature

* In the enervated age of Athens, a law was passed which
confined the practice of midwifery only to the men. It was,
however, repealed, upon a woman's dying in childbirth, ra-
ther than be delivered by a man-midwife. It appears from
the bills of mortality in London and Dublin, that about one
in seventy of those women die in childbirth, who are in the
hands of midwives; but from the accounts of the lying-in
hospitals in those cities, which are under the care of man-
midwives, only one in a hundred and forty perishes in child
birth.

t There has been much common-place declamation
against the custom among the great, of not suckling their

54 NATURAL HISTORY OF MEDICINE

in the preparation and digestion of all our aliment.
Let our fine ladies keep up their colour with car-
mine, and their spirits with ratifia ; and let our
fine gentlemen defend themselves from the excesses
of heat and cold, with lavender and hartshorn.
These customs have become necessary in the cor-
rupt stages of society. We must imitate, in these
cases, the practice of those physicians who consult
the appetite only, in diseases which do not admit of
a remedy.

The state of a country in point of population,
temperance, and industry, is so connected with its
diseases, that a tolerable idea may be formed of it,

children. Nurses were common in Rome, in the declension
of the empire : hence we find Cornelia commended as a
rare example of maternal virtue, as much for suckling her
sons, as for teaching them eloquence. That nurses were
common in Egypt, is probable from the contract which Pha-
raoh's daughter made with the unknown mother of Moses,
to allow her wages for suckling her own child. The same
degrees of civilization require the same customs. A woman
whose times for eating and sleeping are constantly inter-
rupted by the calls of enervating pleasures, must always af-
ford milk of an unwholesome nature. It may truly be said
of a child doomed to live on this aliment, that, as soon as it
receives its

" breath,

It sucks in " the lurking principles of death."

AMONG THE INDIANS. 55

by looking over its bills of mortality. Hospitals,
with all their boasted advantages, exhibit at the
same time monuments of the charity and depravity
of a people*. The opulence of physicians, and

* " Aurengezebe, emperor of Persia, being asked, Why-
he did not build hospitals? said, 1 will make my empire so
rich, that there shall be no need of hospitals. He ought to have
said, I will begin by rendering my subjects rich, and then I
will build hospitals.

" At Rome, the hospitals place every one at his ease, ex-
cept those who labour, those who are industrious, those who
have lands, and those who are engaged in trade.

" I have observed, that wealthy nations have need of hos-
pitals, because fortune subjects them to a thousand acci-
dents ; but it is plain, that transient assistances are better
than perpetual foundations. The evil is momentary ; it is
necessary, therefore, that the succour should be of the same
nature, and that it be applied to particular accidents." Spi-
rit of Laws, b. xxiii. ch. 29.

It was reserved for the present generation to substitute in
the room of public hospitals private dispensaries for the
relief of the sick. Philosophy and Christianity alike concur
in deriving praise and benefit from these excellent institu-
tions. They exhibit something like an application of the
mechanical powers to the purposes of benevolence ; for in
what other charitable institutions do we perceive so great a
quantity of distress relieved by so small an expence ?

56 NATURAL HISTORY OF MEDICINE

the divisions of their offices, into those of surgery,
pharmacy, and midwifery, are likewise pioois of
the declining state of a country. In the infancy
of the Roman empire, the priest performed the
office of a physician ; so simple were the prin-
ciples and practice of physic. It was only in the
declension of the empire that physicians vied
with the emperors of Rome in magnificence and
splendour*.

* The first regular practitioners of physic in Rome, were
women and slaves. The profession was confined to them,
above six hundred years. The Romans, during this period,
lived chiefly upon vegetables, particularly upon pulse ; and
hence they were called, by their neighbours, pultifagi.
They were likewise early inured to the healthy employ-
ments of war and husbandry. Their diseases, of course,
were too few and simple to render the cure of them an ob-
ject of liberal profession. When their diseases became
more numerous and complicated, their investigation and
cure required the aids of philosophy. The profession from
this time became liberal ; and maintained a rank with the
other professions which are founded upon the imperfection
and depravity of human institutions. Physicians are as
necessary in the advanced stages of society as surgeons, al-
though their office is less ancient and certain. There are
many artificial diseases, in which they give certain relief;
and even where their art fails, their prescriptions are still
necessary, in order to smooth the avenues of death.

AMONG THE INDIANS-. 57

I am sorry to add, in this place, that the number
of patients in the hospital, and incurables in the
almshouse of this city, show that we are treading
in the enervated steps of our fellow subjects in
Britain. Our bills of mortality likewise show the
encroachments of British diseases upon us. The
nervous fever has become so familiar to us, that
we look upon it as a natural disease. Dr. Syden-
ham, so faithful in his histoiy of fevers, takes
no notice of it. Dr. Cadwallader informed me,
that it made its first appearance in this city about
five and twenty years ago. It will be impossible to
name the consumption without recalling to our
minds the memory of some friend or relation, who
has perished within these few years by that dis-
ease. Its rapid progress among us has been un-
justly attributed to the growing resemblance of
our climate to that of Great-Britain. The hys-
teric and hypochondriac diseases, once
peculiar to the chambers of the great, are now to
be found in our kitchens and workshops. All
these diseases have been produced by our having
deserted the simple diet and manners of our an-
cestors.

The blessings of literature, commerce, and re-
ligion were not originally purchased at the expence
of health. The complete enjoyment of health is

VOL. I. H

58 NATURAL HISTORY OF MEDICINE

as compatible with civilization, as the enjoyment
of civil liberty. We read of countries, rich in
every thing that can form national happiness and
national grandeur, the diseases of which are nearly
as few and simple as those of the Indians. We
hear of no diseases among the Jews, while they
were under their democratical form of govern-
ment, except such as were inflicted by a superna-
tural power*. We should be tempted to doubt

* The principal employments of the Jews, like those of
the Romans in their simple ages, consisted in war and hus-
bandry. Their diet was plain, consisting chiefly of vegeta-
bles. Their only remedies were plasters and ointments ;
which were calculated for those diseases which are produced
by accidents. In proportion as they receded from their
simple customs, we find artificial diseases prevail among
them. The leprosy made its appearance in their journey
through the wilderness. King Asa's pains in his feet, were
probably brought on by a fit of the gout. Saul and Nebu-
chadnezzar were afflicted with a melancholy. In the time
of our Saviour, we find an account of all those diseases in
Judea, which mark the declension of a people ; such as, the
palsy, epilepsy, mania, blindness, hemorrhagia uterina, &c.
It is unnecessary to suppose, that they were let loose at this
juncture, on purpose to give our Saviour an opportunity of
making them the chief subject of his miracles. They had
been produced from natural causes, by the gradual depravity
of their manners. It is remarkable, that our Saviour chose
those artificial diseases for the subject of his miracles, in
preference to natural diseases. The efforts of nature, and

AMONG THE INDIANS. 59

the accounts given of the populousness of that
people, did we not see the practice of their simple
customs producing nearly the same populousness
in Egypt, Rome, and other countries of anti-
quity. The empire of China, it is said, contains
more inhabitants than the whole of Europe. The
political institutions of that country have exempted
its inhabitants from a large share of the diseases of
other civilized nations. The inhabitants of Swis-
serland, Denmark, Norway*, and Sweden, enjoy
the chief advantages of civilization without having
surrendered for them the blessings of natural health.
But it is unnecessary to appeal to ancient or re-
mote nations to prove, that health is not incompa-
tible with civilization. The inhabitants of many
parts of New-England, particularly of the province
of Connecticut, are but little affected by artificial dis-
eases. Some of you may remember the time, and

the operation of medicines, are too slow and uncertain in
these cases to detract in the least from the validity of the
miracle. He cured Peter's mother-in-law, it is true, of a
fever ; but to show that the cure was miraculous, the sacred
historian adds (contrary to what is common after a fever),
" that she arose immediately*, and ministered unto them."

* In the city of Bergen, which consists of 30,000 inhabi-
tants, there is but one physician ; who is supported at the
expense of the public. Pontoppidan's Nat. Hist, of Norway,

60 NATURAL HISTORY OF MEDICINE

our fathers have told those of us who do not, when
the diseases of Pennsylvania were as few and
as simple as those of the Indians. The food of
the inhabitants was then simple ; their only drink
was water ; their appetites were restrained by la-
bour ; religion excluded the influence of sickening
passions ; private hospitality supplied the want of
a public hospital ; nature was their only nurse, and
temperance their principal physician. But I must
not dwell upon this retrospect of primaeval manners ;
and I am too strongly impressed with a hope of a
revival of such happy days, to pronounce them the
golden age of our province.

Our esteem for the customs of our savage
neighbours will be lessened, when we add, that
civilization does not preclude the honours of old
age. The proportion of old people is much
greater among civilized, than among savage na-
tions. It would be easy to decide this assertion
in our favour, by appealing to facts in the natural
histories of Britain, Norway, Sweden, North- Ame-
rica*, and several of the West- India islands.

* It has been urged against the state of longevity in
America, that the Europeans, who settle among us, gene-
rally arrive to a greater age than the Americans. This
is not occasioned so much by a peculiar firmness in their
stamina, as by an increase of vigour which the constitu-

AMONG THE INDIANS. 61

The laws of decency and nature are not ne-
cessarily abolished by the customs of civilized na-
tions. In many of these, we read of women among
whom nature alone still performs the office of a
midwife*, and who feel the obligations of suck-
ling their children to be equally binding with the
common obligations of morality.

tion acquires by a change of climate. A Frenchman (ce-
teris paribus) outlives an Englishman in England. A
Hollander prolongs his life by removing to the Cape of
Good Hope. A Portuguese gains fifteen or twenty years
by removing to Brazil. And there are good reasons to
believe, that a North-American would derive the same ad-
vantages, in point of health and longevity, by removing to
Europe, which a European derives from coming to this
country.

From a calculation made by an ingenious foreigner, it
appears, that a greater proportion of old people are to be
found in Connecticut, than in any colony in North-Ameri-
ca. This colony contains 180,000 inhabitants. They have
no public hospitals or poor-houses ; nor is a beggar to be
seen among them. There cannot be more striking proofs
than these facts of the simplicity of their manners.

* Parturition, in the simple ages of all countries, is per-
formed by nature. The Israelitish women were delivered
even without the help of the Egyptian midwives. We read
of but two women who died in child-birth in the whole
history of the Jews. Dr. Bancroft says, that child-bearing

62 NATURAL HISTORY OF MEDICINE

Civilization does not render us less fit for the
necessary hardships of war. We read of armies
of civilized nations, who have endured degrees of
cold, hunger, and fatigue, which have not been
exceeded by the savages of any country*.

Civilization does not always multiply the ave-
nues of death. It appears from the bills of mor-
tality, of many countries, that fewer in proportion
die among civilized, than among savage nations.

is attended with so little pain in Guiana, that the women
seem to be exempted from the curse inflicted upon Eve.
These easy births are not confined to warm climates. They
are equally safe and easy in Norway and Iceland, according^
to Pontoppidan and Anderson's histories of those countries,

* Civilized nations have, in the end, always conquered
savages as much by their ability to bear hardships, as by
their superior military skill. Soldiers are not to be chosen
indiscriminately. The greatest generals have looked upon
sound constitutions to be as essential to soldiers, as bravery
or military discipline. Count Saxe refused soldiers born and
bred in large cities ; and sought for such only as were bred
in mountainous countries. The King of Prussia calls young
soldiers only to the dangers and honours of the field, in his
elegant poem, Sur l'Art de la Guerre, chant 1. Old sol-
diers generally lose the advantages of their veteranism, by
their habits of idleness and debauchery. An able general,
and experienced officers, will always supply the defects of
age in young soldiers.

AMONG THE INDIANS. 63

Even the charms of beauty are heightened by
civilization. We read of stateliness, proportion,
fine teeth* and complexions, in both sexes,
forming the principal outlines of national charac-
ters.

The danger of many diseases is not propor-
tioned to their violence, but to their duration.
America has advanced but a few paces in luxury
and effeminacy. There is yet strength enough
in her vitals to give life to those parts which are
decayed. She may tread back her steps. For
this purpose,

I. Let our children be educated in a manner
more agreeable to nature.

* Bad teeth are observed chiefly in middle latitudes,
which are subject to alternate heats and colds. The inha-
bitants of Norway and Russia are as remarkable for their
fine teeth as the inhabitants of Africa. We observe fine
teeth to be universal likewise among the inhabitants of
France, who live in a variable climate. These have been
ascribed to their protecting their heads from the action of
the night air by means of woollen night-caps, and to the
extraordinary attention to the teeth of their children. These
precautions secure good teeth ; and are absolutely necessary
in all variable climates, where people do not adopt all the
customs of the savage life.

.'

64 NATURAL HISTORY OF MEDICINE

II. Let the common people (who constitute the
wealth and strength of our country) be preserved
from the effects of ardent spirits. Had I a double
portion of all that eloquence which has been em-
ployed in describing the political evils that lately
threatened our country, it would be too little to set
forth the numerous and complicated physical and
moral evils which these liquors have introduced
among us. To encounter this hydra requires an
arm accustomed, like that of Hercules, to vanquish
monsters. Sir William Temple tells us, that for-
merly in Spain no man could be admitted as an
evidence in a court, who had once been convicted
of drunkenness. I do not call for so severe a law
in this country. Let us first try the force of se-
vere manners. Lycurgus governed more by these,
than by his laws. " Boni mores non bonae leges,"
according to Tacitus, were the bulwarks of virtue
among the ancient Germans.

III. I despair of being able to call the votaries
of Bacchus from their bottle, and shall therefore
leave them to be roused by the more eloquent
twinges of the gout.

IV. Let us be cautious what kind of manufac-
tures we admit amongr us. The rickets made their
first appearance in the manufacturing towns in

AMONG THE INDIANS. 65

England. Dr. Fothergill informed me, that he
had often observed, when a pupil, that the greatest
part of the chronic patients in the London Hospi-
tal were Spittal-field weavers. I would not be
understood, from these facts, to discourage those
manufactures which employ women and children :
these suffer few inconveniences from a sedentary-
life : nor do I mean to offer the least restraint to
those manufactories among men, which admit of
free air, and the exercise of all their limbs. Per-
haps a pure air, and the abstraction of spiritous li-
quors, might render sedentary employments less
unhealthy in America, even among men, than in
the populous towns of Great-Britain.

The population of a country is not to be accom-
plished by rewards and punishments. And it is
happy for America, that the universal prevalence
of the protestant religion, the checks lately given
to negro slavery, the general unwillingness among
us to acknowledge the usurpations of primogeni-
ture, the universal practice of inoculation for the
small-pox, and the absence of the plague, render
the interposition of government for that purpose
unnecessary.

These advantages can only be secured to our
country by agriculture. This is the true basis

VOL. I. I

66 NATURAL HISTORY OF MEDICINE

of national health, riches, and populousness. Na-
tions, like individuals, never rise higher than when
they are ignorant whether they are tending. It
is impossible to tell from history what will be
the effects of agriculture, industry, temperance,
and commerce, urged on by the competition of
colonies, united in the same general pursuits, in a
country, which for extent, variety of soil, climate,
and number of navigable rivers, has never been
equalled in any quarter of the globe. America is
the theatre where human nature will probably
receive her last and principal literary, moral, and
political honours.

But I recal myself from the ages of futurity*
The province of Pennsylvania has already shown
to her sister colonies, the influence of agriculture
and commerce upon the number and happiness of
a people. It is scarcely a hundred years since
our illustrious legislator, with a handful of men,
landed upon these shores. Although the perfection
of our government, the healthiness of our climate,
and the fertility of our soil, seemed to ensure a
rapid settlement of die province ; yet it would
have required a prescience bordering upon divine,
to have foretold, that in such a short space of
time, the province would contain above 300,000
inhabitants; and that nearly 30,000 of this number

AMONG THE INDIANS. 67

should compose a city, which should be the third,
if not the second in commerce in the British em-
pire. The pursuits of literature require leisure
and a total recess from clearing forests, planting,
building, and all the common toils of settling a
new country : but before these arduous works
were accomplished, the sciences, ever fond of
the company of liberty and industry, chose this
spot for the seat of their empire in this new world.
Our college, so catholic in its foundation, and
extensive in its objects, already sees her sons exe-
cuting offices in the highest departments of soci-
ety. I have now the honour of speaking in the
presence of a most respectable number of philoso-
phers, physicians, astronomers, botanists, patriots,
and legislators ; many of whom have already seized
the prizes of honour, which their ancestors had
allotted to a much later posterity. Our first offer-
ing had scarcely found its way into the temple of
fame, when the oldest societies in Europe turned
their eyes upon us, expecting with impatience to
see the mighty fabric of science, which, like a well-
built arch, can only rest upon the whole of its
materials, completely finished from the treasures
of this unexplored quarter of the globe.

It reflects equal honour upon our society and
the honourable assembly of our province, to ac-

68 NATURAL HISTORY OF MEDICINE, &C.

knowledge, that we have always found the latter
willing to encourage by their patronage, and re-
ward by their liberality, all our schemes for pro-
moting useful knowledge. What may we not ex-
pect from this harmony between the sciences and
government! Methinks I see canals cut, rivers
once impassable rendered navigable, bridges erect-
ed, and roads improved, to facilitate the expor-
tation of grain. I see the banks of our rivers
vying in fruitfulness with the banks of the river
of Egypt. I behold our farmers nobles; our
merchants princes. But I forbear — imagination
cannot swell with the subject.

I beg leave to conclude, by deriving an argu*
ment from our connection with the legislature, to
remind my auditors of the duty they owe to the
society. Patriotism and literature are here con-
nected together ; and a man cannot neglect the one,
without being destitute of the other. Nature and
our ancestors have completed their works among
us ; and have left us nothing to do, but to enlarge
and perpetuate our own happiness.

AN ACCOUNT

OF THE

CLIMATE OF PENNSYLVANIA,

AND ITS

INFLUENCE UPON THE HUMAN BODY,

AN ACCOUNT

OF THE

CLIMATE OF PENNSYLVANIA, &c.

IN order to render the observations upon
the epidemic diseases which compose the follow-
ing volumes more useful, it will be necessary to pre-
fix to them a short account of the climate of Penn-
sylvania, and of its influence upon the human body.
This account may perhaps serve further, to lead to
future discoveries, and more extensive observa-
tions, upon this subject.

The state of Pennsylvania lies between 39° 43'
25", and 42° north latitude, including, of course,
2° 16' 35", equal to 157 miles from its southern to
its northern boundary. The western extremity of
the state is in the longitude of 5° 23' 40", and the
eastern, is that of 27' from the meridian of Phila-
delphia, comprehending in a due west course 311

72 ACCOUNT OF THE CLIMATE

miles, exclusive of the territory lately purchased
by Pennsylvania from the United States, of which
as yet no accurate surveys have been obtained.
The state is bounded on the south by part of the
state of Delaware, by the whole state of Maryland,
and by Virginia to her western extremity. The
last named state, the territory lately ceded to Con-
necticut, and Lake Erie, (part of which is included
in Pennsylvania) form the western and north-west-
ern boundaries of the state. Part of New- York,
and the territory lately ceded to Pennsylvania, with
a part of Lake Erie, compose the northern, and
another part of New- York, with a large extent of
New- Jersey (separated from Pennsylvania by the
river Delaware), compose the eastern boundaries
of the state. The lands which form these boun-
daries (except a part of the states of Delaware,
Maryland, and New Jersey) are in a state of na-
ture. A large tract of the western and north-east-
ern parts of Pennsylvania are nearly in the same
uncultivated situation.

The state of Pennsylvania is intersected and di-
versified with numerous rivers and mountains. To
describe, or even to name them all, would far
exceed the limits I have proposed to this account
of our climate. It will be sufficient only to remark,
that one of these rivers, viz. the Susquehannaru

OF PENNSYLVANIA. 73

begins at the northern boundary of the state, twelve
miles from the river Delaware, and winding seve-
ral hundred miles, through a variegated country,
enters the state of Maryland on the southern line,
fifty- eight miles westward of Philadelphia ; that
each of these rivers is supplied by numerous streams
of various sizes ; that tides flow in parts of two of
them, viz. in the Delaware and Schuylkill ; that
the rest rise and fall alternately in wet and dry
weather ; and that they descend with great rapi-
dity, over prominent beds of rocks in many places,
until they empty themselves into the bays of Dela-
ware and Chesapeak on the east, and into the Ohio
on the western part of the state.

The mountains form a considerable part of the
state of Pennsylvania. Many of them appear to be
reserved as perpetual marks of the original empire
of nature in this country. The Allegany, which
crosses the state about two hundred miles from
Philadelphia, in a north, inclining to an eastern
course, is the most considerable and extensive of
these mountains. It is called by the Indians the
back-bone of the continent. Its heighth, in different
places, is supposed to be about 1,300 feet from the
adjacent plains.

VOL. i. K

74 ACCOUNT OF THE CLIMATE

The soil of Pennsylvania is diversified by its vi-
cinity to mountains and rivers. The vallies and
bottoms consist of a black mould, which extends
from a foot to four feet in depth. But in general
a deep clay forms the surface of the earth. Im-
mense beds of limestone lie beneath this clay in
many parts of the state. This account of the soil
of Pennsylvania is confined wholly to the lands on
the east side of the Allegany mountain. The soil
on the west side of this mountain, shall be described
in another place.

The city of Philadelphia lies in the latitude of
39° 57', in longitude 75° 8' from Greenwich, and
fifty-five miles west from the Atlantic ocean.

It is situated about four miles due north from
the conflux of the rivers Delaware and Schuylkill.
The buildings, which consist chiefly of brick, ex-
tend nearly three miles north and south along the
Delaware, and above half a mile due west towards
the Schuylkill, to which river the limits of the
city extend, the whole of which includes a distance
of two miles from the Delaware. The land near
the rivers, between the city and the conflux of the
rivers, is in general low, moist, and subject to be
overflowed. The greatest part of it is meadow

OF PENNSYLVANIA. 75

ground. The land to the northward and west-
ward, in the vicinity of the city, is high, and in
general well cultivated. Before the year 1778,
the ground between the present improvements of
the city, and the river Schuylkill, was covered
with woods. These, together with large tracts of
wood to the northward of the city, were cut down
during the winter the British army had posses-
sion of Philadelphia. I shall hereafter mention the
influence which the cutting down of these woods,
and the subsequent cultivation of the grounds in
the neighbourhood of the city, have had upon the
health of its inhabitants.

The mean height of the ground on which the
city stands, is about forty feet above the river De-
laware. One of the longest and most populous
streets in the city rises only a few feet above the
river. The air at the north is much purer than
at the south end of the city ; hence the lamps
exhibit a fainter flame in its southern than its
northern parts.

The tide of the Delaware seldom rises more
than six feet. It flows four miles in an hour. The
width of the river near the city is about a mile,

76 ACCOUNT OF THE CLIMATE

The city, with the adjoining districts of South-
wark and the Northern Liberties, contains between
70 and 80,000 inhabitants.

From the accounts which have been handed
down to us by our ancestors, there is reason to
believe that the climate of Pennsylvania has under-
gone a material change. Thunder and lightning
are less frequent, and the cold of our winters and
heat of our summers are less uniform, than they
were forty or fifty years ago. Nor is this all.
The springs are much colder, and the autumns
more temperate than formerly, insomuch that cat-
tle are not housed so soon by one month as they
were in former years. Within the last eight years,
there have been some exceptions to part of these
observations. The winter of the year 1779-80,
was uniformly and uncommonly cold. The river
Delaware was frozen near three months during
this winter, and public roads for waggons and
sleighs connected the city of Philadelphia in many
places with the Jersey shore. The thickness of
the ice in the river near the city, was from sixteen
to nineteen inches, and the depth of the frost in
the ground was from four to five feet, according
to the exposure of the ground, and the quality of
the soil. This extraordinary depth of the frost in
the earth, compared with its depth in more nor-

OF PENNSYLVANIA.

thern and colder countries, is occasioned by the
long delay of snow, which leaves the earth without
a covering during the last autumnal and the first
winter months. Many plants were destroyed by
the intenseness of the cold during this winter. The
ears of horned cattle and the feet of hogs exposed
to the air, were frost-bitten ; squirrels perished in
their holes, and partridges were often found dead
in the neighbourhood of farm houses. The mer-
curv in Januarv stood for several hours at 5° be-
low 0, in Fahrenheit's thermometer; and during the
whole of this month (except on one day), it never
rose in the city of Philadelphia so high as to the
freezing point. ,

The cold in the winter of the year 1783-4 was
as intense, but not so steady, as it was in the winter
that has been described. It differed from it mate-
rially in one particular, viz. there was a thaw in
the month of January, which opened all our rivers
for a few days.

The summer which succeeded the winter of
1779-80, was uniformly warm. The mercury in
the thermometer, during this summer, stood on one
day (the 15th of August) at 95°, and fluctuated
between 93°, and 80° for many weeks. The
thermometer, in every reference that has been, or

78 ACCOUNT OF THE CLIMATE

shall be made to it, stood in the shade in the open
air.

I know it has been said by many old people,
that the winters in Pennsylvania are less cold, and
the summers less warm, than they were forty or
fifty years ago. The want of therm ometrical ob-
servations before, and during those years, renders it
difficult to decide this question. Perhaps the diffe-
rence of clothing and sensation between youth and
old age, in winter and summer, may have laid
the foundation of this opinion. I suspect the
mean temperature of the air in Pennsylvania has
not altered, but that the principal change in our
climate consists in the heat and cold being less
confined than formerly to their natural seasons. I
adopt the opinion of Doctor Williamson* respect-
ing the diminution of the cold in the southern, be-
ing occasioned by the cultivation of the northern
parts of Europe ; but no such cultivation has taken
place in the countries which lie to the north-west
of Pennsylvania, nor do the partial and imperfect
improvements which have been made in the north-
west parts of the state, appear to be sufficient to
lessen the cold, even in the city of Philadelphia.
I have been able to collect no facts, which dispose

* American Philosophical Transactions, vol. I.

OF PENNSYLVANIA. 79

me to believe that the winters were colder before
the year 1740, than they have been since. In the
memorable winter of 1739-40, the Delaware was
crossed on the ice, in sleighs, on the 5th of March,
old style, and did not open till the 13th of the
same month. The ground was covered during
this winter with a deep snow, and the rays of the
sun were constantly obscured by a mist, which
hung in the upper regions of the air. In the win*
ter of 1779-80, the river was navigable on the 4th
of March ; the depth of the snow was moderate,
and the gloominess of the cold was sometime sus-
pended for a few days by a cheerful sun. From
these facts, it is probable the winter of 1739-40
was colder than the winter of 1779-80.

The winter of 1804-5 exhibited so many pecu-
liarities that it deserves a place in the history of
the climate of Pennsylvania. The navigation of
the Delaware was obstructed on the 18th of De-
cember. The weather partook of every disagreea-
ble and distressing property of every cold climate on
the globe. These were intense cold, deep snows,
hail, sleet, high winds, and heavy rains. They
generally occurred in succession, but sometimes
most of them took place in the course of four and
twenty hours. A serene and star-light evening,
often preceded a tempestuous day. The mercury

80 ACCOUNT OF THE CLIMATE

stood for many days, in Philadelphia, at 4° and 6°
above 0 in Fahrenheit's thermometer. The me-
dium depth of the snow was two feet, but from its
fall being accompanied with high winds, its height
in many places was three and four feet, particularly
in roads, which it rendered so impassable, as to
interrupt business and social intercourse, in many
parts of the state. From the great depth of the
snow, the ground was so much protected from the
cold, that the frost extended but six inches below
i^s surface. The newspapers daily furnished dis-
tressing accounts of persons perishing with the cold
by land and water, and of shipwrecks on every
part of the coast of the United States. Poultry
were found dead, or with frozen feet, in their coops,
in many places.

This intense cold wras not confined to Pennsyl-
vania. In Norfolk, in Virginia, the mercury stood
at 18° above 0 on the 22d of January. At Lex-
ington, in Kentucky, it stood at 0 on the 21st of
the same month. In Lower Canada the snow was
seven feet in depth, which is three feet deeper than
in common years. And such was the quantity of
ice collected in the northern seas, that a ship was
destroyed, and several vessels injured, by large
masses of it, floating between the 41st and 42d de-
grees of north latitude.

OF PENNSYLVANIA. 81

Great fears were entertained of an inundation in
Pennsylvania, from a sudden thaw of the immense
quantities of snow and ice that had accumulated
during the winter, in every part of the state ; but
happily they both dissolved away so gradually, as
scarcely to injure a bridge or a road. On the
28th of February the Delaware was navigable, and
on the 2d of March no ice was to be seen in it.

Having premised these general remarks, I pro-
ceed to observe, that there are seldom more than
twenty or thirty days in summer or winter, in
Pennsylvania, in which the mercury rises above 80°
in the former, or falls below 30° in the latter sea-
son. Some old people have remarked, that the
number of extremely cold and warm days in suc-
cessive summers and winters, bears an exact pro-
portion to each other. This was strictly true in
the years 1787 and 1788.

The warmest part of the day in summer is at
two, in ordinary, and at three o'clock in the after-
noon, in extremely warm weather. From these
hours, the heat gradually diminishes till the ensuing
morning. The coolest part of the four and twenty
hours, is at the break of day. There are seldom
more than three or four nights in a summer in
which the heat of the air is nearly the same as in

VOL. I. l

82 ACCOUNT OF THE CLIMATE

the preceding day. After the warmest days, the
evenings are generally agreeable, and often delight-
ful. The higher the mercury rises in the day-
time, the lower it falls the succeeding night. The
mercury at 80° generally falls to 68°, while it
descends, when at 60°, but to 56°. This dispro-
portion between the temperature of the day and
night, in summer is always greatest in the month
of August. The dews at this time are heavy in
proportion to the coolness of the evening. They
are sometimes so considerable as to wet the clothes ;
and there are instances in which marsh-meadows,
and even creeks, which have been dry during the
summer, have been supplied with their usual wa-
ters from no other source, than the dews which
have fallen in this month, or in the first weeks of
September.

There is another circumstance connected with
the one just mentioned, which contributes very
much to mitigate the heat of summer, and that is*
it seldom continues more than two or three days
without being succeeded with showers of rain, ac*
companied sometimes by thunder and lightning,
and afterwards by a north-west wind, which pro-
duces a coolness in the air that is highly invigo-
rating and agreeable.

OF PENNSYLVANIA.

The warmest weather is generally in the month
of July. But intensely warm days are often felt in
May, June, August, and September. In the an-
nexed table of the weather for the year 1787, there
is an exception to the first of these remarks. It
shows that the mean heat of August was greater
by a few degrees than that of July.

The transitions from heat to cold are often very
sudden, and sometimes to very distant degrees.
After a day in which the mercury has stood at
86° and even 90°, it sometimes falls, in the course
of a single night, to the 65th, and even to the
60th degree, insomuch that fires have been found
necessary the ensuing morning, especially if the
change in the temperature of the air has been
accompanied by rain and a south-east wind. In
a summer month, in the year 1775, the mercury
was observed to fall 20° in an hour and a half.
There are few summers in which fires are not
agreeable during some parts of them. My inge-
nious friend, Mr. David Rittenhouse, whose talent
for accurate observation extends alike to all sub-
jects, informed me, that he had never passed a
summer, during his residence in the country, with-
out discovering frost in every month of the year,
except July.

84 ACCOUNT OF THE CLIMATE

The weather is equally variable in Pennsylvania
during the greatest part of the winter. The mer-
cury fell from 37° to 4i° below 0 in four and
twenty hours, between the fourth and fifth of Feb-
ruary, 1788. In this season nature seems to play
at cross purposes. Heavy falls of snow are often
succeeded in a few days by a general thaw, which
frequently in a short time leaves no vestige of the
snow. The rivers Delaware, Schuylkill, and Sus-
quehannah have sometimes been frozen (so as to
bear horses and carriages of all kinds) and thawed
so as to be passable in boats, two or three times in
the course of the same winter. The ice is formed
for the most part in a gradual manner, and seldom
till the water has been previously chilled by a fall
of snow. Sometimes its production is more sud-
den. On the night of the 31st of December,
1764, the Delaware was completely frozen over
between ten o'clock at night and eight the next
morning, so as to bear the weight of a man. An
unusual vapour like a fog was seen to rise from
the water, in its passage from a fluid to a solid
state.

This account of the variableness of the weather
in winter, does not apply to every part of Penn-
sylvania. There is a line about the 41° of the
state, beyond which the winters are steady and

OF PENNSYLVANIA. 85

regular, insomuch that the earth there is seldom
without a covering of snow during the three win-
ter months. In this line the climate of Pennsylva-
nia forms a union with the climate of the eastern
and northern states.

The time in which frost and ice begin to show
themselves in the neighbourhood of Philadelphia,
is generally about the latter end of October or the
beginning of November. But the intense cold
seldom sets in till about the the 20th or 25th of De-
cember; hence the common saying, " as the day
" lengthens, the cold strengthens." The coldest
weather is commonly in January. The navigation
of the river Delaware, after being frozen, is seldom
practicable for large vessels, before the first week
in March.

As in summer there are often days in which fires
are agreeable, so there are sometimes days in win-
ter in which they are disagreeable. Vegetation
has been observed in all the winter months. Gar-
lic was tasted in butter in January, 1781. The
leaves of the willow, the blossoms of the peach
tree, and the flowers of the dandelion and the cro-
cus, were all seen in February, 1779 ; and I well
recollect, when a school-boy, to have seen
an apple orchard in full bloom, and small ap-

86 ACCOUNT OF THE CLIMATE

« pies on many of the trees, in the month of De-
cember.

A cold day in winter is often succeeded by a
moderate evening. The coldest part of the four
and twenty hours, is generally at the break of day.

In the most intense cold which has been re-
corded in Philadelphia, within the last twenty years,
the mercury stood at 5° below 0. But it appears
from the accounts published by Messieurs Mason
and Dixon, in the 58th volume of the Transactions
of the Royal Society of London, that the mercury
stood at 22° below 0, on the 2d of January, 1767,
at Brandywine, about thirty miles to the westward
of Philadelphia. They inform us, that on the 1st
of the same month, the mercury stood at 20°, and
on the dav before at 7° below 0. I have to lament
that I am not able to procure any record of the
temperature of the air in the same year in Phila-
delphia. From the variety in the height and qua-
lity of the soil, and from the difference in the
currents of winds and the quantity of rain and
snow which fall in different parts of the state, it is
very probable this excessive cold may not have
extended thirty miles from the place where it was
first perceived.

OF PENNSYLVANIA. 87

The greatest degree of heat upon record in Phi-
ladelphia, is 95°.

The standard temperature of the air in the city
of Philadelphia is 52^°, which is the temperature
of our deepest wells, as also the mean heat of our
common spring water.

The spring in Pennsylvania is generally less
pleasant than in many other countries. In March
the weather is stormy, variable, and cold. In
April, and sometimes in the beginning of May, it
is moist, and accompanied by a degree of cold
which has been called rawness, and which, from
its disagreeable effects upon the temper, has been
called the sirocco of this country. From the vari-
able nature of the weather in the spring, vegetation
advances very differently in different years. The
colder the spring, the more favourable it proves to
the fruits of the earth. The hopes of the farmer
from his fruit-trees in a warm spring are often
blasted by a frost in April and May. A fall of
snow is remembered with regret by many of them,
on the night between the 3d and 4th of May, in
the year 1774 ; also on the morning of the 8th of
May, 1803. Such was its quantity on the latter
day, that it broke down the limbs of many poplar
trees. This effect was ascribed to its not being

88 ACCOUNT OF THE CLIMATE

accompanied with any wind. The colder the win-
ter, the greater delay we generally observe in the
return of the ensuing spring.

Sometimes the weather during the spring months
is cloudy and damp, attended occasionally with a
gentle fall of rain resembling the spray from a cata-
ract of water. A day of this kind of weather is
called, from its resemblance to a damp day in
Great-Britain, " an English day." This damp
weather seldom continues more than three or four
days. The month of May, 1786, will long be
remembered, for having furnished a very uncom-
mon instance of the absence of the sun for fourteen
days, and of constant damp or rainy weather.

The month of June is the only month in the
year which resembles a spring month in the south-
ern countries of Europe. The weather is then
generally temperate, the sky is serene, and the ver-
dure of the country is universal and delightful.

The autumn is the most agreeable season in the
year in Pennsylvania. The cool evenings and
mornings, which generally begin about the first
week in September, are succeeded by a moderate
temperature of the air during the day. This
kind of weather continues with an increase of cold

OF PENNSYLVANIA. 89

scarcely perceptible, till the middle of October,
when the autumn is closed by rain, which some-
times falls in such quantities as to produce de-
structive freshes in the rivers and creeks, and
sometimes descends in gentle showers, which con-
tinue, with occasional interruptions by a few fair
days, for two or three weeks. These rains are
the harbingers of the winter ; and the Indians have
long ago taught the inhabitants of Pennsylvania,
that the degrees of cold during the winter, are in
proportion to the quantity of rain which falls during
the autumn*.

From this account of the temperature of the air
in Pennsylvania, it is evident that there are seldom

* I cannot help agreeing with Mr. Kirvvan, in one of his
remarks upon the science of meteorology, in the preface to
his estimate of the temperature of different latitudes. " This
" science (says he), if brought to perfection, would enable
" us at least to foresee those changes in the weather which
" we could not prevent. Great as is the distance between
" such knowledge and our own present attainments, we have
" no reason to think it above the level of the powers of the
" human mind. The motions of the planets must have ap-
" peared as perplexed and intricate to those who first con-
" templated them ; yet, by persevering industry, they are
" now known to the utmost precision. The present is (as
" the great Leibnitz expresses it) in every case pregnant

VOL. I. M

90 ACCOUNT OF THE CLIMATE

more than four months in which the weather is
agreeable without a fire.

In winter the winds generally come from the
north-west in fair, and from the north-east in nvet
weather. The north-west winds are uncommonly
dry as well as cold. It is in consequence of the
violent action of these winds that trees have uni-
formly a thicker and more compact bark on their
northern than on their southern exposures. Even
brick houses are affected by the force and dryness
of these north-west winds : hence it is much more
difficult to demolish the northern than the southern
walls of an old brick house. This fact was com-
municated to me by an eminent bricklayer in the
city of Philadelphia.

The winds in fair weather in the spring, and
in warm weather in the summer, blow from the
south-v/est and from west- north-west. The raw
air before-mentioned comes from the north-east.
The south-west winds likewise usually bring with

a with the future, and the connection must be found by long
" and attentive observation."

The influence which the perfection of this science must
have upon health, agriculture, navigation, and commerce, is
too obvious to be mentioned.

OF PENNSYLVANIA. 91

them those showers of rain in the spring and sum-
mer which refresh the earth. They moreover
moderate the heat of the weather, provided they
are succeeded by a north-west wind. Now and
then showers of rain come from the west-north-
west.

There is a common fact connected with the ac-
count of the usual winds in Pennsylvania, which
it may not be improper to mention in this place.
While the clouds are seen flying from the south-
west, the scud, as it is called, or a light vapour, is
seen at the same time flying below the clouds from
the north-east.

The moisture of the air is much greater than
formerly, occasioned probably by the exhalations
which in former years fell in the form of snow,
now descending in the form of rain. The depth
of the snow is sometimes between two and three
feet, but in general seldom exceeds between six
and nine inches.

Hail frequently descends with snow in winter.
Once in four or five years large and heavy showers
of hail fall in the spring and summer. They
generally run in narrow veins (as they are called)

92 ACCOUNT OF THE CLIMATE

of thirty or forty miles in length, and two or three
miles in breadth. The heaviest shower of hail that
is remembered in Philadelphia, did not extend in
breadth more than half a mile north and south.
Some of the stones weighed half an ounce. The
windows of many houses were broken by them.
This shower fell in May, 1783.

From sudden changes in the air, rain and snow
often fall together, forming what is commonly call-
ed sleet.

In the uncultivated parts of the state, the snow
sometimes lies on the ground till the first week in
April. The backwardness of the spring has been
ascribed to the passage of the air over the undis-
solved beds of snow and ice which usually remain,
after the winter months are past, on the north-west
grounds and waters of the state, and of the adja-
cent country.

The dissolution of the ice and snow in the spring
is sometimes so sudden as to swell the creeks and
rivers in every part of the state to such a degree,
as not only to lay waste the hopes of the husband-
man from the produce of his lands, but in some
instances to sweep his barns, stables, and even his

OF PENNSYLVANIA. 93

dwelling house into their currents*. The wind,
during a general thaw, comes from the south-west
or south-east.

* The following account of the thaw of the river Susque-
hannah, in the spring of 1784, was published by the author
in the Columbian Magazine, for November, 1786. It may
serve to illustrate a fact related formerly in the history of
the winters in Pennsylvania, as well as to exhibit an extra-
ordinary instance of the destructive effects of a sudden thaw.

" The winter of 1783-4 was uncommonly cold, inso-
much that the mercury in Fahrenheit's thermometer stood
several times at 5 degrees below 0. The snows were fre-
quent, and, in many places, from two to three feet deep,
during the greatest part of the winter. All the rivers in
Pennsylvania were frozen, so as to bear waggons and sleds
with immense weights. In the month of January a thaw
came on suddenly, which opened our rivers so as to set the
ice a-driving, to use the phrase of the country. In the
course of one night, during the thaw, the wind shifted sud-
denly to the north-west, and the weather became intensely
cold. The ice, which had floated the day before, was sud-
denly obstructed ; and in the river Susquehannah, the ob-
structions were formed in those places where the water was
most shallow, or where it had been accustomed to fall.
This river is several hundred miles in length, and from half
a mile to a mile and a half in breadth, and winds through a
hilly, and in many places a fertile and highly cultivated
country. It has as yet a most difficult communication with
our bays and the sea, occasioned by the number and height
of the falls which occur near the mouth of the river. The

94 ACCOUNT OF THE CLIMATE

The air, when dry in Pennsylvania, has a pecu-
liar elasticity, which renders the heat and cold

ice in many places, especially where there were falls, formed
a kind of dam, of a most stupendous height. About the
middle of March our weather moderated, and a. thaw be-
came general. The effects of it were remarkable in all our
rivers ; but in none so much as in the river I have men-
tioned. I shall therefore endeavour in a few words to de-
scribe them. Unfortunately the dams of ice did not give
way all at once, nor those which lay nearest to the mouth
of the river, first. While the upper dams were set afloat
by the warm weather, the lower ones, which were the
largest, and in which, of course, the ice was most impacted,
remained fixed. In consequence of this, the river rose in a
few hours, in many places, above 30 feet, rolling upon its
surface large lumps of ice, from 10 to 40 cubic feet in size.
The effects of this sudden inundation were terrible. Whole
farms were laid under water. Barns, stables, horses, cat-
tle, fences, mills of every kind, and, in one instance, a large
stone house, 40 by 30 feet, were carried down the stream.
Large trees were torn up by the roots ; several small islands,
covered with woods, were swept away, and not a vestige of
them was left behind. On the barns which preserved their
shape, in some instances, for many miles were to be seen
living fowls ; and, in one dwelling, a candle was seen to
burn for some time, after it was swept from its foundation.
Where the shore was level, the lumps of ice, and the ruins
of houses and farms, were thrown a quarter of a mile from
the ordinary height of the river. In some instances, farms
were ruined by the mould being swept from them by the
cakes of ice, or by depositions of sand ; while others were
enriched by large depositions of mud. The damage, upon

OF PENNSYLVANIA. 95

less insupportable than the same degrees of both
are in moister countries. It is in those cases only
when summer showers are not succeeded by north-
west winds, that the heat of the air becomes op-
pressive and distressing, from being combined
with moisture.

From tradition, as well as living observation, it
is evident, that the waters in many of the creeks
in Pennsylvania have diminished considerably with-
in the last fifty years. Hence many mills, erected
upon large and deep streams of water, now stand
idle in dry weather ; and many creeks, once navi-
gable in large boats, are now impassable even in
canoes. This diminution of the waters has been

the whole, done to the state of Pennsylvania by this fresh,
was very great. In most places it happened in the day
time, or the consequences must have been fatal to many
thousands."

" I know of but one use that can be derived from record-
ing the history of this inundation. In case of similar obstrucr
tions of rivers, from the causes such as have been describ-
ed, the terrible effects of their being set in motion by means
of a general thaw may in part be obviated, by removing such
things out of the course of the water and ice as are within
our power ; particularly cattle, hay, grain, fences, and farm-
ing utensils of all kinds,"

96 ACCOUNT OF THE CLIMATE

ascribed to the application of a part of them to the
purpose of making meadows.

The mean elevation of the barometer in Phila-
delphia, is about 30 inches. The variations in
the barometer are veiy inconsiderable in the great-
est changes of the weather, which occur in the
city of Philadelphia. During the violent and de-
structive storm which blew from the south-west on
the 11th of November, 1788, it suddenly fell from
30 to 29T3o. Mr. Rittenhouse informs me, that
long and faithful observations have satisfied him,
that the alterations in the height of the mercury
in the barometer do not precede but always succeed
changes in the weather. It falls with the south
and south-west, and rises with the north and north-
west winds.

The quantity of water which falls in rain and
snow, one year with another, amounts to from 24
to 36 inches. But to complete the account of
variable qualities in the climate, it will be neces-
sary to add, that our summers and autumns are
sometimes marked by a deficiency, and sometimes
by an excessive quantity of rain. The summer and
autumn of 1782 were uncommonly dry. Near
two months elapsed without a single shower of
rain. There were only two showers in the whole

OF PENNSYLVANIA. 97

months of September and October. In conse-
quence of this dry weather, there was no second
crop of hay. The Indian corn failed of its in-
crease in many places, and was cut down for food
for cattle. Trees newly planted, died. The pas-
ture fields not only lost their verdure, but threw
up small clouds of dust when agitated by the feet
of men, or beasts. Cattle in some instances were
driven many miles to be watered, every morning
and evening. It was remarked during this dry
weather, that the sheep were uncommonly fat, and
their flesh well tasted, while all the other domestic
animals languished from the want of grass and
water. The earth became so inflammable in some
places, as to burn above a foot below its surface.
A complete consumption of the turf by an acci-
dental fire kindled in the adjoining state of New-
Jersey, spread terror and distress through a large
tract of country. Springs of water and large creeks
were dried up in many parts of the state. Rocks
appeared in the river Schuylkill, which had never
been observed before, by the oldest persons then
alive. On one of them were cut the figures 1701.
The atmosphere, during part of this dry weather,
was often filled, especially in the mornings, with a
thin mist, which, while it deceived with the expec-
tation of rain, served the valuable purpose of abat-
ing the heat of the sun. A similar mist was ob-

VOL. I. N

98 ACCOUNT OF THE CLIMATE

served in France by Dr. Franklin, in the summer
of 1782. The winter which succeeded it was un-
commonly cold in France, as well as in Pennsyl-
vania. I am sorry that I am not able to furnish
the mean heat of each of the summer months.
My notes of the weather enable me to add nothing
further upon this subject, than that the summer
was " uncommonly cool."

The summer of the year 1788 afforded a re-
markable instance of excess in the quantity of rain
which sometimes falls in Pennsylvania. Thirteen
days are marked with rain in July, in the records
of the weather kept at Spring- Mill. There fell
on the 18th and 19th of August seven inches of
rain in the city of Philadelphia. The wheat suf-
fered greatly by the constant rains of July in the
eastern and middle parts of the state. So unpro-
ductive a harvest in grain, from wet weather, had
not been known, it is said, in the course of the last
70 years. The heat of the air, during these sum-
mer months was very moderate. Its mean tem-
perature at Spring-Mill was 67,8 in June, 74,7 in
July, and only 70,6 in August.

It is some consolation to a citizen of Pennsylva-
nia, in recording facts which seem to militate
against our climate, to reflect that the difference of

OF PENNSYLVANIA. 99

the weather, in different parts of the state, at the
same season, is happily accommodated to promote
an increase of the same objects of agriculture ; and
hence a deficiency of crops has never been known
in any one year throughout the whole state.

The aurora borealis and meteors are seen occa-
sionally in Pennsylvania. In the present imperfect
state of our knowledge of their influence upon the
human body, it will be foreign to the design of
this history of our climate to describe them.

Storms and hurricanes are not unknown in Penn-
sylvania. They occur once in four or five years,
but they are most frequent and destructive in the
autumn. They are generally accompanied by rain.
Trees are torn up by the roots, and the rivers and
creeks are sometimes swelled so suddenly as to do
considerable damage to the adjoining farms. The
wind, during these storms, generally blows from
the south-east and south-west. In the storms
which occurred in September, 1769, and in the
same month of the year 1785, the wind veered
round contrary to its usual course, and blew from
the north.

After what has been said, the character of the
climate of Pennsylvania may be summed up in a

JOO ACCOUNT OF THE CLIMATE

few words. There are no two successive years
alike. Even the same successive seasons and
months differ from each other every year. Per-
haps there is but one steady trait in the character
of our climate, and that is, it is uniformly variable.

To furnish the reader with a succinct view of
the weather in Pennsylvania, that includes all the
articles that have been mentioned, I shall here sub-
join a table containing the result of meteorological
observations made near the river Schuylkill, for one
year, in the neighbourhood of Philadelphia, by an
ingenious French gentleman, Mr. Legeaux, who
divides his time between rural employments, and
useful philosophical pursuits. This table is ex-
tracted from the Columbian Magazine, for Febru-
ary, 1788. The height of Spring- Mill above the
city of Philadelphia, is supposed to be about 70 feet.

OF PENNSYLVANIA.

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102 ACCOUNT OF THE CLIMATE

It is worthy of notice, how near the mean heat
of the year, and of the month of April, in two
successive years, are to each other in the same
place. The mean heat of April, 1787, was 54°3,
that of April, 1783, was 52°2. By the table of
the mean heat of each month in the year, it ap-
pears that the mean heat of 1787 was 53°5 at
Spring- Mill.

The following accounts of the climates of Pekin
and Madrid, which lie within a few minutes of
the same latitude as Philadelphia, may serve to
show how much climates are altered by local and
relative circumstances. The account of the tem-
perature of the air at Pekin will serve further to
show, that with all the advantages of the highest
degrees of cultivation which have taken place in
China, the winters are colder, and the summers
warmer there than in Pennsylvania, principally
from a cause which will probably operate upon the
winters of Pennsylvania for many centuries to come,
viz. the vicinity of an uncultivated north-west
country.

" Pekin, lat. 39° 54', long. 116° 29' W.

" By five years observations, its annual mean
temperature was found to be 55° 5'<

OF PENNSYLVANIA.

103

January

20°,75

July

84°,8

February

32

August

83

March

48

September

63

April

59

October

52

May

72

November

41

June

83,75

December

27

" The temperature of the Atlantic under this
parallel is 62, but the standard of this part of the
g]obe is the North Pacific, which is here 4 or 5
degrees colder than the Atlantic. The Yellow
Sea is the nearest to Pekin, being about 200 miles
distant from it ; but it is itself cooled by the moun-
tainous country of Corea, which interposes between
it and the ocean, for a considerable part of its ex-
tent. Besides, all the northern parts of China (in
which Pekin lies) must be cooled by the vicinity
of the mountains of Chinese Tartary, among which
the cold is said to be excessive.

" The greatest cold usually experienced during
this period was 5°, the greatest heat, 98°: on
the 25th of July, 1773, the heat arose to 108°
and 110° : a N. E. or N. W. wind produces the
greatest cold, a S. or S. W. or S. E. the greatest
heat*."

* " 6. Mem. Scav. Etrang. p. 528."

104 ACCOUNT OF THE CLIMATE

*" Madrid, lat. 40° 25', long. 3° 20' E.

il The usual heat in summer is said to be from
75° to 85° ; even at night it seldom falls below
70° ; the mean height of the barometer is 27,96.
It seems to be about 1900 feet above the level of
the sea*."

The above accounts are extracted from Mr. Kir-
wan's useful and elaborate estimate of the tempera-
ture of different latitudes.

The history which has been given of the cli-
mate of Pennsylvania, is confined chiefly to the
countiy on the east side of the Allegany moun-
tain. On the west side of this mountain, the cli-
mate differs materially from that of the south-
eastern parts of the state in the temperature of
the air, in the effects of the winds upon the wea-
ther, and in the quantity of rain and snow which
falls every year. The winter seldom breaks up on
the mountains before the 25th of March. A fall
of snow was once perceived upon it, which mea-
sured an inch and a half, on the 11th dav of June.
The trees which grow upon it are small, and In-
dian corn is with difficulty brought to maturity,

* " Mem. Par. 1777, p. 146."

OF PENNSYLVANIA. 105

even at the foot of the east side of it. The south-
west winds on the wrest side of the mountain are
accompanied by cold and rain. The soil is rich,
consisting of near a foot, in many places, of black
mould. The roads in this country are muddy in
winter, but seldom dusty in summer. The ar-
rangement of strata of the earth on the west side,
differs materially from their arrangement on the
east side the mountain. " The country (says Mr.
" Rittenhouse, in a letter to a friend in Philadel-
" phia*), when viewed from the western ridge of
" the Allegany, appears to be one vast extended
" plain. All the various strata of stone seem to
" lie undisturbed in the situation in which they
" were first formed, and the layers of stone, sand,
" clay, and coal, are nearly horizontal."

The temperature of the air on the west is sel-
dom so hot, or so cold, as on the east side of the
mountain. By comparing the state of a thermo-
meter examined by Dr. Bedford at Pittsburg,
284 miles from Philadelphia, it appears that the
weather was not so cold by twelve degrees in that
town, as it was in Philadelphia, on the 5th of Feb-
ruary, 1788.

* Columbian Magazine, for October, 1786.
VOL. I. O

106 ACCOUNT OF THE CLIMATE

To show the difference between the weather at
Spring- Mill and in Pittsburg, I shall here sub-
join an account of it, in both places, the first
taken by Mr. Legaux, and the other by Doctor
Bedford.

OF PENNSYLVANIA,

107

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108 ACCOUNT OF THE CLIMATE

From a review of all the facts which have been
mentioned, it appears that the climate of Pennsyl-
vania is a compound of most of the climates in the
world. Here we have the moisture of Britain in
the spring, the heat of Africa in summer, the tem-
perature of Italy in June, the sky of Egypt in the
autumn, the cold and snows of Norway and the
ice of Holland in the winter, the tempests (in a
certain degree) of the West- Indies in every season,
and the variable winds and weather of Great-Bri-
tain in every month of the year.

From this history of the climate of Pennsylva-
nia, it is easy to ascertain what degrees of health,
and what diseases prevail in the state. As we have
the climates, so we have the health, and the acute
diseases, of all the countries that have been men-
tioned. Without attempting to enumerate the
diseases, I shall only add a few words upon the
time and manner in which they are produced.

I. It appears from the testimonies of many aged
persons, that pleurisies and inflammatory diseases
of all kinds, are less frequent now than they were
forty or fifty years ago.

II. It is a well known fact, that intermitting and
bilious fevers have increased in Pennsylvania in

OF PENNSYLVANIA. 109

proportion as the country has been cleared of its
wood, in many parts of the state.

III. It is equally certain that these fevers have
lessened, or disappeared, in proportion as the coun-
try has been cultivated.

IV. Heavy rains and freshes in the spring sel-
dom produce fevers, unless they are succeeded by
unseasonably warm weather.

V. Sudden changes from great heat to cold, or
cool weather, if they occur before the 20th of Au-
gust, seldom produce fevers. After that time, they
are generally followed by them.

VI. The same state of the atmosphere, whether
cold or warm, moist or dry, continued for a long
time, without any material changes, is always
healthy. Acute and inflammatory fevers were in
vain looked for in the cold winter of 1779-80.
The dry summer of 1782, and the wet summer of
1788, were likewise uncommonly healthy in the
city of Philadelphia. These facts extend only to
those diseases which depend upon the sensible qua-
lities of the air, for diseases from miasmata and con-
tagion, are less influenced by the uniformity of the
weather. The autumn of 1780 was very sickly in

110 ACCOUNT OF THE CLIMATE

Philadelphia, from the peculiar situation of the
grounds in the neighbourhood of the city, while
the countiy was uncommonly healthy. The dry
summer and autumn of 1782 were uncommonly
sickly in the country, from the extensive sources
of morbid exhalations which were left by the dimi-
nution of the waters in the creeks and rivers.

VII. Diseases are often generated in one season
and produced in another. Hence we frequently
observe fevers of different kinds to follow every
species of the weather that was mentioned in the
last observation.

VIII. The excessive heat in Pennsylvania has
sometimes proved fatal to persons who have been
much exposed to it. Its morbid effects discover
themserves by a difficulty of breathing, a general
languor, and, in some instances, by a numbness
and an immobility of the extremities. The exces-
sive cold in Pennsylvania has more frequently
jfroved fatal, but it has been chiefly to those per-
sons who have sought a defence from it, by large
draughts of spiritous liquors. Its operation in
bringing on sleepiness previous to death, is well
known. On the 5th of February, 1788, many
people were affected by the cold. It produced a
violent pain in the head ; and, in one instance, a

OF PENNSYLVANIA, 111

sickness at the stomach, and a vomiting appeared
to be the consequence of it. I have frequently
observed that a greater number of old people die,
during the continuance of extreme cold and warm
weather, than in the same number of days in mo-
derate weather.

IX. May and June are usually the healthiest
months in the year.

X. The influence of the winds upon health, de-
pends very much upon the nature of the country
over which they pass. Winds which pass over
mill-dams and marshes in August and September,
generally carry with them the seeds of fevers.

XL The country in the neighbourhood of Phi-
ladelphia was formerly more sickly than the central
parts of the city, after the 20th of August. Since
the year 1793, the reverse of this has been the case.

XII. The night-air is always unwholesome from
the 20th of August, especially during the passive
state of the system in sleep. The frequent and
sudden changes of the air from heat to cold render
it unsafe to sleep with open windows, during the
autumnal months.

112 ACCOUNT OF THE CLIMATE

XIII. Valetudinarians always enjoy the most
health in Pennsylvania in the summer and winter
months. The spring, in a particular manner, is
very unfavourable to them.

I shall conclude the account of the influence of
the climate of Pennsylvania upon the human body,
with the following observations.

1. The sensations of heat and cold are influenced
so much by outward circumstances, that we often
mistake the degrees of them by neglecting to use
such conveniences as are calculated to obviate the
effects of their excess. A native of Jamaica often
complains less of the heat, and a native of Canada
of the cold, in their respective countries, than they
do under certain circumstances in Pennsylvania.
Even a Pennsylvania!! frequently complains less of
the heat in Jamaica, and of the cold in Canada,
than in his native state. The reason of this is
plain. In countries where heat and cold are in-
tense and regular, the inhabitants guard them-
selves, by accommodating their houses and dresses
to each of them. The instability and short dura-
tion of excessive heat and cold in Pennsylvania,
have unfortunately led its inhabitants, in many in-
stances, to neglect adopting customs, which are
used in hot and cold countries to guard against

./

OF PENNSYLVANIA. 113

them. Where houses are built with a southern
or south-western front exposure, and where other
accommodations to the climate are observed in
their construction, the disagreeable excesses of heat
and cold are rendered much less perceptible in
Pennsylvania. Perhaps the application of the
principles of philosophy and taste to the construc-
tion of our houses, within the last thirty or forty
years, may be another reason why some old people
have supposed that the degrees of heat and cold
are less in Pennsylvania than they were in former
years.

2. The variable nature of the climate of Penn-
sylvania does not render it necessarily unhealthy.
Doctor Huxham has taught us, that the healthiest
seasons in Great-Britain have often been accompa-
nied by the most variable weather. His words
upon this subject convey a reason for the fact.
" When the constitutions of the year are frequently
" changing, so that by the contrast a sort of cqui-
" librium is kept up, and health with it; and that
" especially if persons are careful to guard them-
" selves well against these sudden changes*. "
Perhaps no climate or country is unhealthy, where
men acquire from experience, or tradition, the arts

* Observations on the Air and Epidemic Diseases, vol 1. p. 5.
VOL. I. P

114 ACCOUNT OF THE CLIMATE, &C.

of accommodating themselves to it. The history
of all the nations of the world, whether savage,
barbarous, or civilized, previously to a mixture of
their manners by an intercourse with strangers,
seems to favour this opinion. The climate of Chi-
na appears, in many particulars, to resemble that
of Pennsylvania. The Chinese wear loose gar-
ments of different lengths, and increase or diminish
the number of them, according to the frequent and
sudden changes of their weather ; hence they have
very few acute diseases among them. Those in-
habitants of Pennsylvania who have acquired the
arts of conforming to the changes and extremes of
our weather in dress, diet, and manners, escape
most of those acute diseases which are occasioned
by the sensible qualities of the air ; and faithful in-
quiries and observations have proved, that they
attain to as great ages as the same number of peo-
ple in any part of the world.

AN ACCOUNT

OF THE

BILIOUS REMITTING FEVER,

AS IT APPEARED

IJY PHILADELPHIA,

IN THE SUMMER AND AUTUMN OF THE YEAR 1780,

AN ACCOUNT

OF THE

BILIOUS REMITTING FEVER, &c.

BEFORE I proceed to describe this fever,
it will be necessary to give a short account of the
weather, and of the diseases which preceded its
appearance.

The spring of 1780 was dry and cool. A ca-
tarrh appeared among children between one year,
and seven years of age. It was accompanied by a
defluxion from the eyes and nose, and by a cough
and dyspnoea, resembling, in some instances, the
cynanche trachealis, and in others a peripneumony.
In some cases it was complicated with the symp-
toms of a bilious remitting, and intermitting fever.
The exacerbations of this fever were always at-
tended with dyspnoea and cough. A few patients
expectorated blood. Some had swellings behind

118 ACCOUNT OF THE

their ears, and others were affected with small ul-
cers in the throat. I met with only one case of
this fever in which the pulse indicated bleeding.
The rest yielded in a few days to emetics, blisters,
and the bark, assisted by the usual more simple
remedies in such diseases.

An intermittent prevailed among adults in the
month of May.

July and August were uncommonly warm. The
mercury stood on the 6th of August at 941°, on
the 15th of the same month at 95°, and for several
days afterwards at 90°. Many labouring people
perished during this month by the heat, and by
drinking, not only cold water, but cold liquors of
several kinds, while they were under the violent
impressions of the heat.

The vomiting and purging prevailed universally,
during these two warm months, among the chil-
dren, and with uncommon degrees of mortality.
Children from one year to eight and nine years old
were likewise veiy generally affected by blotches
and little boils, especially in their faces. An erup-
tion on the skin, called by the common people the
prickly heat, was very common at this time among
persons of all ages. The winds during these

BILIOUS REMITTING FEVER. 119

months blew chiefly from the south, and south-
west. Of course they passed over the land which
lies between the city, and the conflux of the ri-
vers Delaware and Schuylkill, the peculiar situa-
tion of which, at that time, has been already de-
scribed.

The dock, and the streets of Philadelphia, sup-
plied the winds at this season, likewise, with a por-
tion of their unwholesome exhalations.

The muschetoes were uncommonly numerous
during the autumn. A certain sign (says Dr.
Lind) of an unwholesome atmosphere.

The remitting fever made its first appearance in
July and August, but its symptoms were so mild,
and its extent so confined, that it excited no ap-
prehensions of its subsequent more general preva-
lence throughout the city.

On the 19th of August the air became suddenly
very cool. Many hundred people in the city com-
plained, the next day, of different degrees of in-
disposition, from a sense of lassitude, to a fever of
the remitting type. This was the signal of the
epidemic. The weather continued cool during
the remaining part of the month, and during the

120 ACCOUNT OF THE

whole month of September. From the exposure
of the district of South wark (which is often distin-
guished by the name of the Hill J to the south-west
winds, the fever made its first appearance in that
appendage of the city. Scarcely a family, and, in
many families, scarcely a member of them, escaped
it. From the Hill it gradually travelled along the
second street from the Delaware, improperly call-
ed Front- street. For a while it was confined to
this street only, after it entered the city, and hence
it was called by some people the Front-street fever.
It gradually spread through other parts of the city,
but with very different degrees of violence. It
prevailed but little in the Northern Liberties. It
was scarcely known beyond Fourth- street from the
Delaware. Intemperance in eating or drinking,
riding in the sun or rain, watching, fatigue, or
even a fright, but more frequently cold, all served
to excite the seeds of this fever into action, where -
ever they existed.

All ages and both sexes were affected by this
fever. Seven of the practitioners of physic were
confined by it nearly at the same time. The city,
during the prevalence of the fever, was filled with
an unusual number of strangers, many of whom,
particularly the Friends (whose yearly meeting
was held in the month of September), were affected

BILIOUS REMITTING FEVER. 121

by it. No other febrile disease was observed du-
ring this time in the city.

This fever generally came on with rigour, but
seldom with a regular chilly fit, and often without
any sensation of cold. In some persons it was in-
troduced by a slight sore throat, and in others by
a hoarseness which was mistaken for a common
cold. A giddiness in the head was the forerunner
of the disease in some people. This giddiness at-
tacked so suddenly, as to produce, in several in-
stances, a faintness, and even symptoms of apo-
plexy. It was remarkable, that all those persons
who were affected in this violent manner, recover-
ed in two or three days.

I met with one instance of this fever attacking
with coma, and another with convulsions, and with
many instances, in which it wras introduced by a
delirium.

The pains which accompanied this fever were
exquisitely severe in the head, back, and limbs.
The pains in the head were sometimes in the back
parts of it, and at other times they occupied only
the eyeballs. In some people, the pains were so
acute in their backs and hips, that they could not
lie in bed. In others, the pains affected the neck

vol. i. %

122 ACCOUNT OF THE

and arms, so as to produce in one instance a diffi-
culty of moving the fingers of the right hand.
They all complained more or less of a soreness in
the seats of these pains, particularly when they oc-
cupied the head and eyeballs. A few complained
of their flesh being sore to the touch, in every part
of the body. From these circumstances, the dis-
ease was sometimes believed to be a rheumatism ;
but its more general name among all classes of
people was, the break-bone fever.

I met with one case of pain in the back, and
another of an acute ear-ach, both of which re-
turned periodically every night, and without any
fever.

A nausea universally, and in some instances a
vomiting, accompanied by a disagreeable taste in
the mouth, attended this fever. The bowels were,
in most cases, regular, except where the disease
fell with its whole force upon them, producing a
dysentery.

The tongue was generally moist, and tinctured
of a yellow colour.

The urine was high coloured, and in its usual
quantity in fevers.

BILIOUS REMITTING FEVER. 123

The skin was generally moist, especially where
the disease terminated on the third or fourth day.

The pulse was quick and full, but never hard, in
a single patient that came under my care, till the
28th of September.

It was remarkable, that little, and, in some in-
stances, no thirst attended this fever.

A screatus, or constant hawking and spitting,
attended in many cases through the whole disease,
and was a favourable symptom.

There were generally remissions in this fever
every morning, and sometimes in the evening.
The exacerbations were more severe every other
day, and two exacerbations were often observed in
one day.

A rash often appeared on the third and fourth
days, which proved favourable. This rash was
accompanied, in some cases, by a burning in the
palms of the hands and soles of the feet. Many
people at this time, who were not confined to their
beds, and some, who had no fever, had an efflores-
cence on dieir skins.

124 ACCOUNT OF THE

In several persons the force of the disease seem-
ed to fall upon the face, producing swellings under
the jaw and in the ears, which in some instances
terminated in abscesses.

When the fever did not terminate on the third
or fourth day, it frequently ran on to the eleventh,
fourteenth, and even twentieth days, assuming in
its progress, according to its duration, the usual
symptoms of the typhus gravior, or mitior, of
Doctor Cullen. In some cases, the discharge of a
few spoons-full of blood from the nose accompanied
a solution of the fever on the third or fourth day ;
while in others, a profuse haemorrhage from the
nose, mouth, and bowels, on the tenth and eleventh
days, preceded a fatal issue of the disease.

Several cases came under my care, in which the
fever was succeeded by a jaundice.

The disease terminated in some cases without
sweating, or a sediment in the urine ; nor did I
observe such patients more disposed to relapse than
others, provided they took a sufficient quantity of
the bark.

About the beginning of October the weather
became cool, accompanied by rain and an easterly

\

BILIOUS REMITTING FEVER. 125

wind. This cool and wet weather continued for
four days. The mercury in the thermometer fell
to 60°, and fires became agreeable. From this
time the fever evidently declined, or was accom-
panied by inflammatory symptoms. On the 16th
of October, I met with a case of inflammatory an-
gina ; and on the next day I visited a patient who
had a complication of the bilious fever with a pleu-
risy, and whose blood discovered strong marks of
the presence of the inflammatory diathesis. His
stools were of a green and black colour. On the
third day of his disease a rash appeared on his
skin, and on the fourth, in consequence of a se-
cond bleeding, his fever terminated with the com-
mon symptoms of a crisis.

During the latter end of October, and the first
weeks in November, the mercury in the ther-
mometer fluctuated between 50° and 60°. Pleu-
risies and inflammatorv diseases of all kinds now
made their appearance. They were more nu-
merous and more acute, than in this stage of the
autumn, in former years. I met with one case of
pleurisy in November, which did not yield to less
than four plentiful bleedings.

I shall now add a short account of the method
I pursued in the treatment of this fever.

126 ACCOUNT OF THE

I generally began by giving a gentle vomit of
tartar emetic. This medicine, if given while the
fever was in its forming state, frequently produced
an immediate cure ; and if given after its forma-
tion, on the^m day, seldom failed of producing a
crisis on the third or fourth day. The vomit
always discharged more or less bile. If a nausea,
or an ineffectual attempt to vomit continued after
the exhibition of the tartar emetic, I gave a se-
cond dose of it with the happiest effects.

If the vomit failed of opening the bowels, I
gave gentle doses of salts and cream of tartar*,
or of the butter-nut pillf, so as to procure two or
three plentiful stools. The matter discharged
from the bowels was of a highly bilious nature.
It was sometimes so acrid as to excoriate the rec-
tum, and so offensive, as to occasion, in some cases,

* I have found that cream of tartar renders the purging
neutral salts less disagreeable to the taste and stomach ; but
accident has lately taught me, that the juice of two limes or
of one lemon, with about half an ounce of loaf sugar, added
to six drachms of Glauber or Epsom salt, in half a pint of
boiling water, form a mixture that is nearly as pleasant as
strong beverage.

t This pill is made from an extract of a strong decoction
of the inner bark of the white walnut-tree.

BILIOUS REMITTING FEVER. 127

sickness and faintness both in the patients and in
their attendants. In every instance, the patients
found relief by these evacuations, especially from
the pains in the head and limbs.

In those cases, where the prejudices of the
patients against an emetic, or where an advanced
state of pregnancy, or a habitual predisposition to
a vomitting of blood occurred, I discharged the
bile entirely by means of the lenient purges that
have been mentioned. In this practice I had the
example of Doctor Cleghorn, who prescribed
purges with great success in a fever of the same
kind in Minorca, with that which has been de-
scribed*. Doctor Lining prescribed purges with
equal success in an autumnal pleurisy in South
Carolina, which I take to have been a form of a
bilious remittent, accompanied by an inflammatory
affection of the breast.

After evacuating the contents of the stomach
and bowels, I gave small doses of tartar emetic,
mixed with Glauber's salt. This medicine excited
a general perspiration. It likewise kept the bowels
gently open, by which means the bile was dis-
charged as fast as it was accumulated.

* The tertiana interposita remissione tantum of Dr. Cullen.

128 ACCOUNT OF THE

I constantly recommended to my patients, in this
stage of the disorder, to lie in bed. This favoured
the eruption of the rash, and the solution of the
disease by perspiration. Persons who struggled
against the fever by sitting up, or who attempted
to shake it off by labour or exercise, either sunk
under it, or had a slow recovery.

A clergyman of a respectable character from
the country, who was attacked by the disease in
the city, returned home, from a desire of being
attended by his own family, and died in a few
days afterwards. This is only one, of many cases,
in which I have observed travelling, even in the
easiest carriages, to prove fatal in fevers after they
were formed, or after the first symptoms had
shown themselves. The quickest and most effec-
tual way of conquering a fever, in most cases, is,
by an early submission to it.

The drinks I recommended to my patients were
sage and balm teas, weak punch, lemonade, wine
whey, tamarind and apple water.

The apple water should be made by pouring
boiling water upon slices of raw apples. It is
more lively than that which is made by pouring
the water on roasted apples.

BILIOUS REMITTING FEVER. 129

I found obvious advantages, in many cases, from
the use of pediluvia, every night.

In every case, I found the patients refreshed and
relieved by frequent changes of their linen.

On the third or fourth day, in the forenoon,
the pains in the head and back generally abated,
with a sweat which was diffused over the whole
body. The pulse at this time remained quick and
weak. This was, however, no objection to the
use of the bark, a few doses of which immediately
abated its quickness, and prevented a return of the
fever.

If the fever continued beyond the third or fourth
day without an intermission, I always had recourse
to blisters. Those which were applied to the
neck, and behind the ears, produced the most
immediate good effects. They seldom failed of
producing an intermission in the fever, the day
after they were applied. Where delirium or coma
attended, I applied the blister to the neck on the
first day of the disease. A worthy family in this
city will always ascribe the life of a promising boy,
of ten years old, to the early application of a blis-
ter to the neck, in this fever.

VOL. I. R

130 ACCOUNT OF THE

Where the fever did not yield to blisters, and
assumed malignant, or typhus symptoms, I gave
the medicines usually exhibited in both those
states of fever.

I took notice, in the history of this fever, that it
was sometimes accompanied with symptoms of
a dysentery. Where this disease appeared, I
prescribed lenient purges and opiates. Where
these failed of success, I gave the bark in the in-
termissions of the pain in the bowels, and applied
blisters to the wrists. The good effects of these
remedies led me to conclude, that the dysentery
was the febris introversa of Dr. Sydenham.

I am happy in having an opportunity, in this
place, of bearing a testimony in favour of the use-
fulness of opium in this disease, after the neces-
sary evacuations had been made. I yielded, in
prescribing it at first, to the earnest solicitations of
my patients for something to give them relief
from their insupportable pains, particularly when
they were seated in the eyeballs and head. Its
salutary effects in procuring sweat, and a remission
of the fever, led me to prescribe it afterwards in
almost every case, and always with the happiest
effects. Those physicians enjoy but little pleasure
in practising physic, who know not how much

BILIOUS REMITTING FEVER. 131

of the pain and anguish of fevers, of a certain
kind, may be lessened by the judicious use of
opium. ■

In treating of the remedies used in this disease,
I have taken no notice of blood-letting. Out of
several hundred patients whom I visited in this
fever, I did not meet with a single case, before the
27th of September, in which the state of the pulse
indicated this evacuation. It is true, the pulse
was fillip but never hard, I acknowledge that I
was called to several patients who had been bled
without the advice of a physician, who recovered
afterwards on the usual days of the solution of
the fever. This only can be ascribed to that dis-
position which Doctor Cleghorn attributes to fevers,
to preserve their types under every variety of treat-
ment, as well as constitution. But I am bound to
declare further, that I heard of several cases in
which bleeding was followed by a fatal termination
of the disease.

In this fever relapses were very frequent, from
exposure to the rain, sun, or night air, and from
an excess in eating or drinking.

The convalescence from this disease was marked
by a number of extraordinary symptoms, which

132 ACCOUNT OF THE

rendered patients the subjects of medical attention
for many days after the pulse became perfectly
regular, and after the crisis of the disease.

A bitter taste in the mouth, accompanied by a
yellow colour on the tongue, continued for near a
week.

Most of those who recovered complained of
nausea, and a total want of appetite. A faintness,
especially upon sitting up in bed, or in a chair,
followed this fever. A weakness in the knees was
universal. I met with two patients, who were most
sensible of this weakness in the right knee. An
inflammation in one eye, and in some instances in
both eyes, occurred in several patients after their
recovery.

But the most remarkable symptom of the con-
valescence from this fever, was an uncommon de-
jection of the spirits. I attended two young ladies,
who shed tears while they vented their complaints
of their sickness and weakness. One of them very
aptly proposed to me to change the name of the
disease, and to call it, in its present stage, instead
of the break-bone, the break-heart fever.

BILIOUS REMITTING FEVER. 133

To remove these symptoms, I gave the tincture
of bark and elixir of vitriol in frequent doses. I
likewise recommended the plentiful use of ripe
fruits ; but 1 saw the best effects from temperate
meals of oysters, and a liberal use of porter. To
these was added, gentle exercise in the open air,
which gradually completed the cure.

AN ACCOUNT

OF THE

SCARLATINA ANGINOSA,

AS IT

APPEARED IN PHILADELPHIA,

IN THE YEARS 1783 AND 1784.

AN ACCOUNT

OF THE

SCARLATINA ANGINOSA, he.

THE beginning of the month of July was
unusually cool ; insomuch that the mercury in Fah-
renheit's thermometer stood at 61° in the day time,
and fires were very comfortable, especially in the
evening. In the last week but one of this month,
the weather suddenly became so warm, that the
mercury rose to 94i°, at which it remained for
three days. As this heat was accompanied by no
breeze from any quarter, the sense of it was ex-
tremely distressing to many people. Upwards of
twenty persons died in the course of those three
days, from the excess of the heat, and from drink-
ing cold water. Three old people died suddenly
within this space of time. This extreme heat was
succeeded by cool weather, the mercury having
vol. i. s

138 ACCOUNT OF THE

fallen to 60°, and the month closed with producing
a few intermitting and remitting fevers, together
with several cases of inflammatory angina.

The weather in the month of August was ex-
tremely variable. The mercury, after standing for
several days at 92°, suddenly fell so low, as not
only to render fires necessary, but in many places
to produce frost.

Every form of fever made its appearance in this
month. The synocha was so acute, in several
cases, as to require from three to four bleedings.
The remitting fever was accompanied by an un-
common degree of nausea and faintness. Several
people died, after a few days' illness, of the malig-
nant bilious fever, or typhus gravior, of Dr. Cul-
len. The intermittents had nothing peculiar in
them, in their symptoms or method of cure.

Towards the close of the month, the scarlatina
anginosa made its appearance, chiefly among chil-
dren.

The month of September was cool and dry, and
the scarlatina anginosa became epidemic among
adults as well as young people. In most of the
patients who were affected by it, it came on with

SCARLATINA ANGINOSA. 139

a chilliness and a sickness at the stomach, or a vo-
miting ; which last was so invariably present, that
it was with me a pathognomonic sign of the dis-
ease. The matter discharged from the stomach
was always bile. The swelling of the throat was
in some instances so great, as to produce a diffi-
culty of speaking, swallowing, and breathing. In
a few instances, the speech was accompanied by a
squeaking voice, resembling that which attends
the cynanche trachealis. The ulcers on the ton-
sils were deep, and covered with white, and, in
some instances, with black sloughs. In several
cases, there was a discharge of a thick mucus from
the nose, from the beginning, but it oftener occur-
red in the decline of the disease, which most fre-
quently happened on the fifth day. Sometimes the
subsiding of the swelling of the throat was follow-
ed by a swelling behind the ears.

An eruption on the skin generally attended the
symptoms which have been described. But this
symptom appeared with considerable variety. In
some people it preceded, and in others it followed
the ulcers and swelling of the throat. In some, it
appeared only on the outside of the throat, and on
the breast; in others, it appeared chiefly on the
limbs. In a few it appeared on the second or third
day of the disease, and never returned afterwards.

140 ACCOUNT OF THE

I saw two cases of eruption without a single symp-
tom of sore throat. The face of one of those pa-
tients was swelled, as in the erisypelas. In the
other, a young girl of seven years old, there was
only a slight redness on the skin. She was seized
with a vomiting, and died delirious in fifty-four
hours. Soon after her death, a livid colour appear-
ed on the outside of her throat.

The bowels, in this degree of the disease, were
in general regular. I can recollect but few cases
which were attended by a diarrhoea.

The fever which accompanied the disease was
generally the typhus mitior of Doctor Cullen. In
a lew cases it assumed symptoms of great malig-
nity.

The disease frequently went off with a swelling
of the hands and feet. I saw one instance in a
gentlewoman, in whom this swelling was absent,
who complained of very acute pains in her limbs,
resembling those of the rheumatism.

In two cases which terminated fatally, there were
large abscesses ; the one on the outside, and the
other on the inside of the throat. The first of
these cases was accompanied by troublesome sores

SCARLATINA ANGINOSA. 141

on the ends of the fingers. One of these patients
lived twenty-eight, and the other above thirty days,
and both appeared to die from the discharge which
followed the opening of their abscesses.

Between the degrees of the disease which I have
described, there were many intermediate degrees
of indisposition which belonged to this disease.

I saw in several cases a discharge from behind
the ears, and from the nose, with a slight eruption,
and no sore throat. All these patients were able
to sit up, and walk about.

I saw one instance of a discharge from the inside
of one of the ears in a child, who had ulcers in
his throat, and the squeaking voice.

In some, a pain in the jaw, with swellings be-
hind the ears, and a slight fever, constituted the
whole of the disease.

In one case, the disease came on with a coma,
and in several patients it went off with this symp-
tom.

A few instances occurred of adults, who walked
about, and even transacted business, until a few
hours before they died.

142 ACCOUNT OF THE

The intermitting fever, which made its appear-
ance in August, was not lost during the month of
September. It continued to prevail, but with se-
veral peculiar symptoms. In many persons it was
accompanied by an eruption on the skin, and a
swelling of the hands and feet. In some, it was
attended by a sore throat and pains behind the ears.
Indeed, such was the predominance of the scarla-
tina anginosa, that many hundred people complained
of sore throats, without any other symptom of in-
disposition. The slightest occasional or exciting
cause, and particularly cold, seldom failed of pro-
ducing the disease.

The month of October was much cooler than
September, and the disease continued, but with less
alarming symptoms. In several adults, who were
seized with it, the hardness of the pulse indicated
blood-letting. The blood, in one case, was co-
vered with a buffy coat, but beneath its surface it
was dissolved.

In the month of November, the disease assumed
several inflammatory symptoms, and was attended
with much less danger than formerly. I visited
one patient whose symptoms were so inflammatory
as to require two bleedings. During the decline
of the disease, many people complained of trouble-

SCARLATINA ANGINOSA. 143

some sores on the ends of their fingers. A number
of children likewise had sore throats and fevers,
with eruptions on their skins, which resembled the
chicken-pox. I am disposed to suspect that this
eruption was the effect of a spice of the scarlatina
anginosa, as several instances occurred of patients
who had all the symptoms of this disease, in whom
an eruption of white blisters succeeded their re-
covery. This form of the disease has been called
by Sauvage, the scarlatina variolosa.

I saw one case of sore throat, which was suc-
ceeded not only by swellings in the abdomen and
limbs, but by a catarrh, which brought on a fatal
consumption.

A considerable shock of an earthquake was felt
on the 29th of this month, at ten o'clock at night,
in the city of Philadelphia ; but no change was
perceived in the disease, in consequence of it.

In December, January, and February, the wea-
ther was intensely cold. There was a thaw for a
few days in January, which broke the ice of the
Delaware, but it was followed by cold so excessive,
as to close the river till the beginning of March.
The mercury, on the 28th and 29th of February,
stood below 0 in Fahrenheit's thermometer.

144 ACCOUNT OF THE

For a few weeks in the beginning of December,
the disease disappeared in the circle of my patients,
but it broke out with great violence the latter end
of that month, and in the January following.
Some of the worst cases that I met with (three of
which proved fatal) were in those two months.

The disease disappeared in the spring, but it
spread afterwards through the neighbouring states
of New-Jersey, Delaware, and Maryland.

I shall now add an account of the remedies
which I administered in this disease.

In every case that I was called to, I began the
cure by giving a vomit joined with calomel. The
vomit was either tartar emetic or ipecacuanha, ac-
cording to the prejudices, habits, or constitutions
of my patients. A quantity of bile was generally
discharged by this medicine. Besides evacuating
the contents of the stomach, it cleansed the throat
in its passage downwards. To ensure this effect
from the calomel, I always directed it to be given
mixed with syrup or sugar and water, so as to
diffuse it generally over every part of the throat.
The calomel seldom failed to produce two or
three stools. In several cases I was obliged, by
the continuance of nausea, to repeat the emetics,

SCARLATINA ANGINOSA. 145

and always with immediate and obvious advantage.
I gave the calomel in moderate doses in every
stage of the disease. To restrain its purgative ef-
fects, when necessary, I added to it a small quan-
tity of opium.

During the whole course of the disease, where
the calomel failed of opening the bowels, I gave
lenient purges, when a disposition to costiveness
required them.

The throat was kept clean by detergent gargles.
In several instances I saw evident advantages from
adding a few grains of calomel to them. In cases
of great difficulty of swallowing or breathing, the
patients found relief from receiving the steams of
warm water mixed with a little vinegar, through a
funnel into the throat.

A perspiration kept up by gentle doses of anti-
monials, and diluting drinks, impregnated with
wine, always gave relief.

In every case which did not yield to the above
remedies on the third day, I applied a blister be-
hind each ear, or one to the neck, and, I think,
always with good effects.

VOL. i. x

146 ACCOUNT OF THE, &X.

I met with no cases in which the bark appeared

to be indicated, except the three in which the

disease proved fatal. Where the sore throat was

blended with the intermitting fever, the bark was

given with advantage. But in common cases it
was unnecessary. Subsequent observations have

led me to believe, with Doctor Withering, that

it is sometimes hurtful in this disease.

It proved fatal in many parts of the country.,
upon its first appearance ; but wherever the mode
of treatment here delivered was adopted, its morta-
lity was soon checked. The calomel was used
very generally in New-Jersey and New- York. In
the Delaware state, a physician of character made
it a practice not only to give calomel, but to anoint
the outside of the throat with mercurial ointment,

ADDITIONAL OBSERVATIONS

UPON THB

Scarlatina Anginosa.

s

THIS disease has prevailed in Philadelphia,
at different seasons, ever since the year 1783. It
has blended itself occasionally with all our epide-
mics. Many cases have come under my notice
since its first appearance, in which dropsical swell-
ings have succeeded the fever. In some instances
there appeared to be effusions of water not only in
the limbs and abdomen, but in the thorax. They
yielded, in every case that I attended, to purges of
calomel and jalap. Where these swellings were
neglected, they sometimes proved fatal.

In the winter of 1786-7, the scarlatina anginosa
was blended with the cynanche parotidea, and in
one instance with a typhus mitior. The last was

148 ADDITIONAL OBSERVATIONS

in a young girl of nine years of age. She was
seized with a vomiting of bile and an efflorescence
on her breast, but discovered no other symptoms
of the scarlatina anginosa till the sixteenth day of
her fever, when a swelling appeared on the outside
of her throat, and after her recovery, a pain and
swelling in one of her knees.

In the month of July, 1787, a number of peo-
ple were affected by sudden swellings of their lips
and eyelids. These swellings generally came on
in the night, were attended with little or no pain,
and went off in two or three days. I met with
only one case in which there was a different issue
to these symptoms. It was in a patient in the
Pennsylvania hospital, in whom a swelling in the
, lips ended in a suppuration, which, notwithstand-
ing the liberal use of bark and wine, proved fatal
in the course of twelve days.

In the months of June and July, 1788, a num-
ber of people were affected by sudden swellings,
not only of the lips, but of the cheeks and throat.
At the same time many persons were affected by
an inflammation of the eyes. The swellings were
attended with more pain than they were the year
before, and some of them required one or two

UPON THE SCARLATINA ANGINOSA. 149

purges to remove them ; but in general they went
without medicine, in two or three days.

Is it proper to refer these complaints to the
same cause which produces the scarlatina an-
ginosa ?

The prevalence of the scarlatina anginosa at
the same time in this city ; its disposition to pro-
duce swellings in different parts of the body ; and
the analogy of the intermitting fever, which often
conceals itself under symptoms that are foreign
to its usual type ; all seem to render this con-
jecture probable. In one of the cases of an in-
flammation of the eye, which came under my
notice, the patient was affected by a vomiting a
few hours before the inflammation appeared, and
complained of a sickness at his stomach for two
or three days afterwards. Now a vomiting and
nausea appear to be veiy generally symptoms of
the scarlatina anginosa.

In the autumn of 1788, the scarlatina anginosa
appeared with different degrees of violence in
many parts of the city. In two instances it ap-
peared with an obstinate diarrhoea ; but it was in
young subjects, and not in adults, as described by
Doctor Withering. In both cases, the disease

150 ADDITIONAL OBSERVATIONS

proved fatal ; the one on the third, the other on
the fifth day.

In the month of December of the same year,
I saw one case in which a running from one of
the ears, and a deafness came on, on the fifth
day, immediately after the discharge of mucus from
the nose had ceased. This case terminated fa-
vourably on the ninth day, but was succeeded,
for several days afterwards, by a troublesome
cough.

I shall conclude this essay by the following
remarks :

1. Camphor has often been suspended in a
bag from the neck, as a preservative against this
disease. Repeated observations have taught me,
that it possesses little or no efficacy for this pur-
pose. I have had reason to entertain a more fa-
vourable opinion of the benefit of washing the
hands and face with vinegar, and of rinsing the
mouth and throat with vinegar and water every
morning, as means of preventing this disease.

2. Whenever I have been called to a patient
where the scarlatina appeared to be in a. forming
state, a vomit of ipecacuanha or tartar emetic,

UPON THE SCARLATINA ANGINOSA. 151

mixed with a few grains of calomel, has never
failed of completely checking the disease, or of so
far mitigating its violence, as to dispose it to a
favourable issue in a few davs ; and if these obser-
vations should serve no other purpose than to
awaken the early attention of patients and physi-
cians to this speedy and effectual remedy, they will
not have been recorded in vain.

3. When the matter which produces this dis-
ease has been received into the body, a purge has
prevented its being excited into action, or rendered
it mild, throughout a whole family. For this
practice I am indebted to some observations on the
scarlatina, published by Dr. Sims in the first vo-
lume of the Medical Memoirs.

4. During the prevalence of the inflammatory
constitution of the atmosphere, between the years
1793 and 1800, this disease occurred occasionally
in Philadelphia, and yielded, like the other epide-
mics of those years, to copious blood-letting, and
other depleting remedies.

AN INQUIRY

INTO

THE CAUSE AND CURE

OF

THE CHOLERA INFANTUM.

VOL. I. U

AN INQUIRY

INTO

THE CAUSE AND CURE

OF

THE CHOLERA INFANTUM.

BY this name I mean to designate a dis-
ease, called, in Philadelphia, the " vomiting and
purging of children." From the regularity of its
appearance in the summer months, it is likewise
known by the name of " the disease of the season."
It prevails in most of the large towns of the United
States. It is distinguished in Charleston, in South
Carolina, by the name of " the April and May
disease," from making its first appearance in
those two months. It seldom appears in Phila-
delphia till the middle of June, or the beginning of
July, and generally continues till near the middle

156 THE CAUSE AND CURE OF

of September. Its frequency and danger are al-
ways in proportion to the heat of the weather. It
affects children from the first or second week after
their birth, till they are two years old. It some-
times begins with a diarrhoea, which continues for
several days without any other symptom of indis-
position ; but it more frequently comes on with a
violent vomiting and purging, and a high fever.
The matter discharged from the stomach and bowels
is generally yellow or green, but the stools are
sometimes slimy and bloody, without any tincture
of bile. In some instances they are nearly as lim-
pid as water. Worms are frequently discharged
in each kind of the stools that has been described.
The children, in this stage of the disease, appear to
suffer a good deal of pain. They draw up their
feet, and are never easy in one posture. The
pulse is quick and weak. The head is unusually
warm, while the extremities retain their natural
heat, or incline to be cold. The fever is of the
remitting kind, and discovers evident exacerba-
tions, especially in the evenings. The disease af-
fects the head so much, as in some instances to
produce symptoms not only of delirium, but of
mania, insomuch that the children throw their
heads backwards and forwards, and sometimes
make attempts to scratch, and to bite their parents,
nurses, and even themselves. A swelling fre-

THE CHOLERA INFANTUM. 157

quently occurs in the abdomen, and in the face and
limbs. An intense thirst attends every stage of
the disease. The eyes appear languid and hollow,
and the children generally sleep with them half
closed. Such is the insensibility of the system in
some instances in this disease, that flies have been
seen to alight upon the eyes when open, without
exciting a motion in the eyelids to remove them.
Sometimes the vomiting continues without the
purging, but more generally the purging continues
without the vomiting, through the whole course of
the disease. The stools are frequently large, and
extremely foetid, but in some instances they are
without smell, and resemble drinks and aliment
which have been taken into the body. The disease
is sometimes fatal in a few days. I once saw it
carry off a child in four and twenty hours. Its
duration is varied by the season of the year, and
by the changes in the temperature of the weather.
A cool day frequently abates its violence, and dis-
poses it to a favourable termination. It often con-
tinues, with occasional variations in its appearance,
for six weeks or two months. Where the disease
has been of long continuance, the approach of
death is gradual, and attended by a number of dis-
tressing symptoms. An emaciation of the body
to such a degree, as that the bones come through
the skin, livid spots, a singultus, convulsions, a

158 THE CAUSE AND CURE OF

strongly marked hippocratic countenance, and a
sore mouth, generally precede the fatal termination
of this disease. Few children ever recover, after
the last symptoms which have been mentioned
make their appearance.

This disease has been ascribed to several causes ;
of each of which I shall take notice in order.

I. It has been attributed to dentition. To refute
this opinion, it will be necessary to observe, that
it appears only in one season of the year. Den-
tition, I acknowledge, sometimes aggravates it;
hence we find it is most severe in that period of
life, when the greatest number of teeth make their
appearance, which is generally about the 10th
month. I think I have observed more children to
die of this disease at that age, than at any other.

II. Worms have likewise been suspected of
being the cause of this disease. To this opinion,
I object the uncertainty of worms ever producing
an idiopathic fever, and the improbability of their
combining in such a manner as to produce an
annual epidemic disease of any kind. But fur-
ther, we often see the disease in all its force,
before that age, in which worms usually produce
diseases ; we likewise often see it resist the most

THE CHOLERA INFANTUM. 159

powerful anthelmintic medicines ; and, lastly, it
appears from dissection, where the disease has
proved fatal, that not a single worm has been dis-
covered in the bowels. It is true, worms are in
some instances discharged in this disease, but
they are frequently discharged in greater numbers
in the hydrocephalus intemus, and in the small-
pox, and yet who will assert either of those dis^
eases to be produced by worms.

III. The summer fruits have been accused of
producing this disease. To this opinion I object,
that the disease is but little known in country
places, where children eat much more fruit than
in cities. As far as I have observed, I am dispos-
ed to believe, that the moderate use of ripe fruits,
rather tends to prevent, than to induce the disease.

From the discharge of bile which generally
introduces the disease, from the remissions and
exacerbations of the fever which accompanies it,
and from its occurring nearly in the same season
with the cholera and remitting fever in adults,
I am disposed to consider it as a modification of
the same diseases. Its appearance earlier in the
season than the cholera and remitting: fever in
adults, must be ascribed to the constitutions of
children being more predisposed from weakness

160 THE CAUSE AND CURE OF

to be acted upon, by the remote causes which
produce those diseases.

I shall now mention the remedies which are
proper and useful in this disease.

I. The first indication of cure is to evacuate
the bile from the stomach and bowels. This
should be done by gentle doses of ipecacuanha, or
tartar emetic. The vomits should be repeated
occasionally, if indicated, in every stage of the
disease. The bowels should be opened by means
of calomel, manna, castor oil, or magnesia. I have
generally found rhubarb improper for this purpose,
while the stomach was in a very irritable state.
In those cases, where there is reason to believe
that the offending contents of the primae viae
have been discharged by nature (which is often
the case), the emetics and purges should by no
means be given ; but, instead of them, recourse
must be had to

II. Opiates. A few drops of liquid laudanum,
combined in a testaceous julep, with peppermint
or cinnamon- water, seldom fail of composing the
stomach and bowels. In some instances, this me-
dicine alone subdues the disease in two or three
days ; but where it does not prove so successful,

THE CHOLERA INFANTUM. 161

it produces a remission of pain, and of other dis-
tressing symptoms, in every stage of the disease.

III. Demulcent and diluting drinks have an
agreeable effect in this disease. Mint and mallow
teas, or a tea made of blackberry roots infused
in cold water, together with a decoction of the
shavings of hartshorn and gum arabic with cinna-
mon, should all be given in their turns for this
purpose.

IV. Glysters made of flaxseed tea, or of mut-
ton broth, or of starch dissolved in water, with
a few drops of liquid laudanum in them, give ease,
and produce other useful effects.

V. Plasters of Venice treacle applied to the re-
gion of the stomach, and flannels dipped in infu-
sions of bitter and aromatic herbs in warm spirits,
or Madeira wine, and applied to the region of the
abdomen, often afford considerable relief.

VI. As soon as the more violent symptoms of
the disease are composed, tonic and cordial medi-
cines should be given. The bark in decoction,
or in substance (where it can be retained in that
form), mixed with a little nutmeg, often produces
the most salutary effects. Port wine or claret

vol. r, x

162 THE CAUSE AND CURE Of

mixed with water are likewise proper in this stage
of the disease. After the disease has continued
for some time, we often see an appetite suddenly
awakened for articles of diet of a stimulating na-
ture. I have seen many children recover from
being gratified in an inclination to eat salted fish,
and the different kinds of salted meat. In some in-
stances they discover an appetite for butter, and
the richest gravies of roasted meats, and eat them
with obvious relief to all their symptoms. I once
saw a child of sixteen months old, perfectly re-
stored, from the lowest stage of this disease, by
eating large quantities of rancid English cheese,
and drinking two or three glasses of port wine
every day. She would in no instance eat bread
with the cheese, nor taste the wine, if it was mix-
ed with water.

We sometimes see relief given by the use of
the warm bath, in cases of obstinate pain. The
bath is more effectual, if warm wine is used, in-
stead of water.

I have had but few opportunities of trying the
effects of cold water applied to the body in this
disease ; but from the benefit which attended its
use in the cases in which it was prescribed, I am
4isposed to believe that it would do great service,

THE CHOLERA INFANTUM. 163

could we overcome the prejudices which subsist in
the minds of parents against it.

After all that has been said in favour of the
remedies that have been mentioned, I am sorry to
add, that I have very often seen them all admini-
stered without effect. My principal dependence,
therefore, for many years, has been placed upon

VII. Country air. Out of many hundred chil-
dren whom I have sent into the country, in every
stage of this disease, I have lost but three ; two
of whom were sent, contrary to my advice, into
that unhealthy part of the neighbourhood of Phi-
ladelphia called the Neck, which lies between the
city and the conflux of the rivers Delaware and
Schuylkill. I have seen one cure performed by
this remedy, after convulsions had taken place.
To derive the utmost benefit from the country aii%
children should be carried out on horseback, or in
a carriage, every day ; and they should be exposed
to the open air as much as possible in fair weather,
in the day time. Where the convenience of the
constant benefit of country air cannot be obtained,
I have seen evident advantages from taking chil-
dren out of the city once or twice a day. It is
extremely agreeable to see the little sufferers revive

164 THE CAUSE AND CURE OF

as soon as they escape from the city air, and in-
spire the pure air of the country.

I shall conclude this inquiry, by recommending
the following methods of preventing this disease,
all of which have been found by experience to be
useful.

1. The daily use of the cold bath.

2. A faithful and attentive accommodation of
the dresses of children, to the state and changes of
the air.

3. A moderate quantity of salted meat taken
occasionally in those months in which this disease
usually prevails. It is perhaps in part from the
daily use of salted meat in diet, that the children
of country people escape this disease.

4. The use of sound old wine in the summer
months. From a tea- spoon- full, to half a wine
glass full, according to the age of the child, may
be given every day. It is remarkable, that the
children of persons in easy circumstances, wTho sip
occasionally with their parents the remains of a
glass of wine after dinner, are much less subject to

THE CHOLERA INFANTUM. 165

this disease, than the children of poor people, who
are without the benefit of that article of diet.

5. Cleanliness, both with respect to the skin
and clothing of children. Perhaps the neglect of
this direction may be another reason why the chil-
dren of the poor, are most subject to this disease.

6. The removal of children into the country
before the approach of warm weather. This ad-
vice is peculiarly necessary during the whole pe-
riod of dentition. I have never known but one
instance of a child being affected by this disscee,
who had been carried into the country in order to
avoid it.

I have only to add to the above observations,
that since the prevalence of the yellow fever in
Philadelphia after the year 1793, the cholera infan-
tum has assumed symptoms of such malignity, as to
require bleeding to cure it. In some cases, two
and three bleedings were necessary for that purpose.

OBSERVATIONS

ON THE

CYNANCHE TRACHEALIS.

OBSERVATIONS

ON THE

CYNANCHE TRACHEALIS.

THE vulgar name of this disease in Penn-
sylvania is hives. It is a corruption of the word
heaves, which took its rise from the manner in
which the lungs heave in breathing. The worst
degree of the disease is called the bowel hives,
from the great motion of the abdominal muscles in
respiration.

It has been called suffocatio stridula by Dr.
Home, and cynanche trachealis by Dr. Cullen.
Professor Frank calls it trachitis, and Dr. Darwin
considers it as a pleurisy of the windpipe. By the
two latter names, the authors mean to convey the
correct idea, that the disease is the same in its na-
ture with the common diseases of other internal
parts of the body.

vox. I. Y

170 OBSERVATIONS ON THE

It is brought on by the same causes which in-
duce fever, particularly by cold. I have seen it
accompany, as well as succeed, the small-pox,
measles, scarlet T fever, and apthous sore throat. In
the late Dr. Foulke it succeeded acute rheuma-
tism. The late Dr. Say re informed me, he had
seen it occur in a case of yellow fever, in the year
1798,

It sometimes comes on suddenly, but it more
frequently creeps on in the form of a common cold.
Its symptoms are sometimes constant, but they
more generally remit, particularly during the day.
It attacks children of all ages, from three months
to five years old. But it occasionally attacks adults.
It generally runs its course in three or four days,
but we now and then see it protracted in a chro-
nic and feeble form, for eight and ten days.

Dissections show the following appearances in
the trachea. 1. A slight degree of inflammation.
2. A thick matter resembling mucus. 3. A mem-
brane similar to that which succeeds inflammation
in the pleura and bowels, formed from the coagu-
lating lymph of the blood. 4. In some cases the
trachea exhibits no marks of disease of any kind.
These cases are generally violent, and terminate
suddenly. The morbid excitement here transcends

CYNANCHE TRACHEALZS. 171

inflammation. Similar instances of the absence of
the common signs of disease after death, occur in
other parts of the body. Where the cynanche tra-
chealis has appeared in the high grade which has
been last mentioned, it has been called spasmodic.
Where the serous vessels of the trachea have been
tinged with red blood, it has been considered as
inflammatory. Where a liquid matter has been
found in the trachea, it has been called humoral ;
and where a membrane has been seen adhering to
the trachea, it has received from Dr. Michaelis the
name of angina polyposa. But all these different
issues of the cynanche trachealis are the effects of
a difference only in its force, or in its duration :
they all depend upon one remote, and one proxi-
mate cause.

In the forming state of this disease, which may
be easily known by a hoarseness, and a slight de-
gree of stertorous cough, a puke of antimonial
wine, tartar emetic, ipecacuanha, or oxymel of
squills, is for the most part an immediate cure.
To be effectual, it should operate four or five
limes. Happily children are seldom injured by a
little excess in the operation of this class of medi-
cines. I have prevented the formation of this dis-
ease many hundred times, and frequently in my
own family, by means of this remedy.

172 OBSERVATIONS ON THE

After the disease is completely formed, and ap*
pears with the usual symptoms described by au-
thors, the remedies should be

1. Blood-letting. The late Dr. Bailie of New-
York used to bleed until fainting was induced. His
practice has been followed by Dr. Dick of Alex-
andria, and with great success. I have generally
preferred small, but frequent, to copious bleedings.
I once drew twelve ounces of blood, at four bleed-
ings, in one day, from a son of Mr. John Carrol,
then in the fourth year of his age. Dr. Physick
bled a child, of but three months old, three times
in one day. Life was saved in both these cases.
Powerful as the lancet is, in this disease, its vio-
lence and danger require that it should be aided by

2. Vomits. These should be given every day,
or oftener, during the continuance of the disease.
Their good effects are much more obvious and
certain in a disease of the trachea, than of the
lungs, and hence their greater utility, as I shall say
hereafter, in a consumption from a catarrh, than
from any other of its causes.

3. Purges. These should consist of calomel
and jalap, or rhubarb, and should always follow

CYNANCHE TRACH£AJ,I$. 173

the use of emetics, if they fail of opening the
bowels.

4. Calomel should likewise be given in large
doses. Dr. Physick gave half a drachm of this
medicine, in one day, to the infant whose ease has
been mentioned. I have never known it excite
a salivation when given to children whose ages
rendered them subjects of it, probably because it
has been given in such large quantities as to pass
rapidly through the bowels. Its good effects seem
to depend upon its exciting a counter-action in the
whole intestinal canal, and thereby lessening the
disposition of the tracheal blood-vessels to dis-
charge the mucus, or form the membrane, which
have been described.

5. Blisters should be applied to the throat,
breast, neck, and even to the limbs.

6. Dr. Archer of Maryland commends, in high
terms, the use of polygola, or Seneka snake-root,
in this disease. I can say nothing in favour of its
exclusive use, from my own experience, having
never given it, but as an auxiliary to other remedies.

7. I have seen great relief given by the use of
the warm bath, especially when it has been follow-
ed by a gentle perspiration.

174 OBSERVATIONS ON THE

8. Towards the close of the disease, after the
symptoms of great morbid action begin to decline,
a few drops of liquid laudanum, by quieting the
cough which generally succeeds it, often produce
the most salutary effects. They should be given
in flaxseed, or bran, or onion tea, of which drinks
the patient should drink freely in every stage of the
disease.

The cynanche trachealis is attended with most
danger, when the patient labours under a constant
and audible stertorous breathing. The danger is
less, when a dry stertorous cough attends, with
easy respiration in its intervals. The danger is
is nearly over, when the cough, though stertorous,
is loose, and accompanied with a discharge of mu-
cus from the trachea.

An eruption of little red blotches, which fre-
quently appears and disappears two or three times
in the course of this disease, is always a favourable
Symptom.

I once attended a man from Virginia, of the
name of Bampfield, who, after an attack of this
disease, was much distressed with the stertorous
breathing and cough which belong to it. I sus-
pected both to arise from a membrane formed by

CYNANCHE TRACHEALIS. 175

inflammation in his trachea. This membrane I
supposed to be in part detached from the trachea,
from the rattling noise which attended his breath-
ing. He had used many remedies for it to no
purpose. I advised a salivation, which in less than
three weeks perfectly cured him.

Since the general adoption of the remedies
which have been enumerated, for the cynanche tra-
chealis, instances of its mortality have become very
uncommon in the city of Philadelphia.

AN ACCOUNT

OF THE EFFICACY OF

BLISTERS AND BLEEDING,

IN THE CURE OF OBSTINATE

Intermitting Fevers

VOL. I. 7,

AN ACCOUNT, &a

THE efficacy of these remedies will proba-
bly be disputed by every regular-bred physician,
who has not been a witness of their utility in the
above disease ; but it becomes such physicians,
before they decide upon this subject, to remember,
that many things are true in medicine, as well as
in other branches of philosophy, which are very
improbable.

In all those cases of autumnal intermittents, whe-
ther quotidian, tertian, or quartan, in which the
bark did not succeed after three or four days trial,
I have seldom found it fail after the application of
blisters to the wrists.

But in those cases where blisters had been ne-
glected, or applied without effect, and where the

180 OF THE EFFECTS OF BLISTERS, &C.

disease had been protracted into the winter months,
I have generally cured it by means of one or two
moderate bleedings.

The pulse in those cases is generally full, and
sometimes a little hard, and the blood when drawn
for the most part appears sizy.

The bark is seldom necessary to prevent the
return of the disease. It is always ineffectual,
where blood-letting is indicated. I have known
several instances where pounds of that medicine
have been taken without effect, in which the loss
of ten or twelve ounces of blood has immediately
cured the disease.

I once intended to have added to this account
of the efficacy of blisters and bleeding in curing
obstinate intermittents, testimonies from a number
of medical gentlemen, of the success with which
they have used them ; but these vouchers have
become so numerous, that they would swell this
essay far beyond the limits I wish to prescribe to it.

AN ACCOUNT

OF

THE DISEASE OCCASIONED

BY

DRINKING COLD WATER

IN WARM WEATHER,

AND THE METHOD OF CURXNG IT.

AN ACCOUNT, &c.

FEW summers elapse in Philadelphia, in
which there are not instances of many persons be-
ing diseased by drinking cold water. In some sea-
sons, four or five persons have died suddenly from
this cause, in one day. This mortality falls chiefly
upon the labouring part of the community, who
.seek to allay their thirst by drinking the water from
the pumps in the streets, and who are too impatient,
or too ignorant, to use the necessary precautions
for preventing its morbid or deadly effects upon
them. These accidents seldom happen, except
when the mercury rises above 85° in Fahrenheit's
thermometer.

Three circumstances generally concur to pro-
duce disease or death, from drinking cold water.
1. The patient is extremely warm. 2. The water

184 OF THE DISORDER OCCASIONED BY

is extremely cold. And 3. A large quantity of
it is suddenly taken into the body. The danger
from drinking the cold water is always in propor-
tion to the degrees of combination which occur in
the three circumstances that have been mentioned.

The following symptoms generally follow, where
cold water has been taken, under the above cir-
cumstances, into the body :

In a few minutes after the patient has swallowed
the water, he is affected by a dimness of sight ; he
staggers in attempting to walk, and, unless sup-
ported, falls to the ground ; he breathes with diffi-
culty ; a rattling is heard in his throat ; his nos-
trils and cheeks expand and contract in every act
of respiration ; his face appears suffused with blood,
and of a livid colour ; his extremities become cold,
and his pulse imperceptible ; and, unless relief be
speedily obtained, the disease terminates in death,
in four or live minutes.

This description includes only the less common
cases of the effects of drinking a large quantity of
cold water, when the body is preternaturally heat-
ed. More frequently, patients are seized with
acute spasms in the breast and stomach. These
spasms are so painful as to produce syncope, and

DRINKING COLD WATER. 185

even asphyxia. They are sometimes of the tonic,
but more frequently of the clonic kind. In the
intervals of the spasms, the patient appears to be
perfectly well. The intervals between each spasm
become longer or shorter, according as the disease
tends to life or death.

It may not be improper to take notice, that
punch, beer, and even toddy, when drunken under
the same circumstances as cold water, have all
been known to produce the same morbid and fatal
effects.

I know of but one certain remedy for this dis-
ease, and that is liquid laudanum. The doses
of it, as in other cases of spasm, should be propor-
tioned to the violence of the disease. From a tea-
spoonful to near a table- spoonful have been given
in some instances, before relief has been obtained.
Where the powers of life appear to be suddenly
suspended, the same remedies should be used,
which have been so successfully employed in re-
covering persons supposed to be dead from drown-
ing.

Care should be taken in every case of disease, or
apparent death, from drinking cold water, to pre-
vol. i. 2 a

186 OF THE DISORDER OCCASIONED BY

vent the patient's suffering from being surrounded,
or even attended by too many people.

Persons who have been recovered from the im-
mediate danger which attends this disease, are
sometimes affected after it, by inflammations and
obstructions in the breast or liver. These gene-
rally yield to the usual remedies which are admi-
nistered in those complaints, when they arise from
other causes.

If neither the voice of reason, nor the fatal ex-
amples of those who have perished from this cause,
are sufficient to produce restraint in drinking a
large quantity of cold liquors, when the body is
preter naturally heated, then let me advise to

1. Grasp the vessel out of which you are about
to drink for a minute or longer, with both your
hands. This will abstract a portion of heat from
the body, and impart it at the same time to the
cold liquor, provided the vessel be made of metal,
glass, or earth ; for heat follows the same laws, in
many instances, in passing through bodies, with
regard to its relative velocity, which we observe to
take place in electricity.

DRINKING COLD WATER. 187

2. If you are not furnished with a cup, and are
obliged to drink by bringing your mouth in con-
tact with the stream which issues from a pump, or
a spring, always wash your hands and face, previ-
ously to your drinking, with a little of the cold
water. By receiving the shock of the water first
upon those parts of the body, a portion of its heat
is conveyed away, and the vital parts are thereby
defended from the action of the cold.

By the use of these preventives, inculcated by
advertisements pasted upon pumps by the Humane
Society, death from drinking cold water has be-
come a rare occurrence for many years past in
Philadelphia.

AN ACCOUNT

OF THE

EFFICACY OF COMMON SALT,

IN THE CURE OF

HEMOPTYSIS.

AN ACCOUNT, &c.

FROM the present established opinions
and practice respecting the cause and cure of hae-
moptysis, the last medicine that would occur to a
regular- bred physician for the cure of it, is com-
mon salt ; and yet I have seen and heard of a
great number of cases, in which it has been admi-
nistered with success.

The mode of giving it is to pour down from a
tea to a table -spoonful of clean fine salt, as soon
as possible after the haemorrhage begins from the
lungs. This quantity generally stops it ; but the
dose must be repeated daily for three or four days,
to prevent a return of the disease. If the bleed-
ing continue, the salt must be continued till it is
checked, but in larger doses. I have heard of se-
veral instances in which two table spoons- full were
taken at one time for several days.

192 THE EFFICACY OF COMMON SALT

It sometimes excites a sickness at the stomach,
and never fails to produce a burning sensation in
the throat, in its passage into the stomach, and
considerable thirst afterwards.

I have found this remedy to succeed equally-
well in haemorrhages, whether they occurred in
young or in old people, or with a weak or active
pulse.

I had prescribed it for several years before I
could satisfy myself with a theory, to account for
its extraordinary action upon the human body.
My inquiries led me to attend more particularly
to the following facts :

1. Those persons who have been early instruct-
ed in vocal music, and who use their vocal organs
moderately through life, are seldom affected by a
haemorrhage from the lungs.

2. Lawyers, players, public cryers, and city
watchmen, all of whom exercise their lungs either
by long or loud speaking, are less affected by this
disease, than persons of other occupations.

I acknowledge I cannot extend this observation
to the public teachers of religion. I have known

IN THE CURE OF HAEMOPTYSIS. 193

several instances of their being affected by hae-
moptysis ; but never but one in which the disease
came on in the pulpit, and that was in a person
who had been recently cured of it. The cases
which I have seen, have generally been brought on
by catarrhs.

To this disease, the practice of some of our
American preachers disposes them in a peculiar
manner ; for it is very common with this class of
them, to expose themselves to the cold or evening
air, immediately after taking what a celebrated and
eloquent preacher used to call a pulpit sweat,

3. This haemorrhage chiefly occurs in debili-
tated habits, or in persons afflicted by such a pre-
disposition to consumption, as indicates a weak and
relaxed state of the lungs.

4. It generally occurs when the lungs are in a
passive state ; as in sitting, walking, and more fre-
quently in lying. Many of the cases that I have
known, have occurred during sleepy in the middle
of the night.

From these facts, is it not probable that the
common salt, by acting primarily and with great
force upon the throat, extends its stimulus to the

vol. i. 2 b

194 THE EFFICACY OF COMMON SALT

bleeding vessel, and by giving it a tone, checks the
further effusion of blood ?

I shall only add to this conjecture the following
observations :

1. I have never known the common salt per-
form a cure, where the haemorrhage from the lungs
has been a symptom of a confirmed consumption.
But even in this case it gives a certain temporary-
relief.

2. The exhibition of common salt in the hae-
moptysis, should by no means supersede the use
of occasional bleeding when indicated by plethora,
nor of that diet which the state of the pulse, or of
the stomach, may require.

3. I have given the common salt in one case
with success, in a haemorrhage from the stomach,
accompanied by a vomiting ; and have heard of
several cases in which it has been supposed to have
checked a discharge of blood from the nose and
uterus, but I can say nothing further in its favour
in these last haemorrhages, from my own expe-
rience.

IN THE CURE OF HEMOPTYSIS. 195

It may perhaps serve to lessen the prejudices
of physicians against adopting improvements in
medicine, that are not recommended by the autho-
rity of colleges or universities, to add, that we are
indebted to an old woman, for the discovery of the
efficacy of common salt in the cure of haemoptysis.

THOUGHTS

UPON

THE CAUSE AND CURE

OF THE

PULMONARY CONSUMPTION.

THOUGHTS, &c.

THE ancient Jews used to say, that a man
does not fulfil his duties in life, who passes through
it, without building a house, planting a tree, and
leaving a child behind him. A physician, in like
manner, should consider his obligations to his pro-
fession and society as undischarged, who has not at-
tempted to lessen the number of incurable diseases.
This is my apology for presuming to make the
consumption the object of a medical inquiry.

Perhaps I may suggest an idea, or fact, that may
awaken the ideas and facts which now lie useless
in the memories or common-place books of other
physicians ; or I may direct their attention to some
useful experiments upon this subject.

I shall begin my observations upon the consump-
tion, by remarking,

200 THOUGHTS ON THE CONSUMPTION.

1. That it is unknown among the Indians in
North- America.

2. It is scarcely known by those citizens of the
United States, who live in the first stage of civi-
lized life, and who have lately obtained the title of
the first settlers*

The principal occupations of the Indian consist
in war, fishing, and hunting. Those of the first
settler, are fishing, hunting, and the laborious
employments of subduing the earth, cutting down
forests, building a house and barn, and distant
excursions, in all kinds of weather, to mills and
courts, all of which tend to excite and preserve in
die system, something like the Indian vigour of
constitution.

3. It is less common in country places than in
cities, and increases in both, with intemperance
and sedentary modes of life.

4. Ship and house carpenters, smiths, and all
those artificers whose business requires great ex-
ertions of strength in the open air, in all seasons of
the year, are less subject to this disease, than men
who work under cover, and at occupations which
do not require the constant action of their limbs.

THOUGHTS ON THE CONSUMPTION1. 201

5. Women, who sit more than men, and whose
work is connected with less exertion, are most sub-
ject to the consumption.

From these facts it would seem, that the most
probable method of curing the consumption, is
to revive in the constitution, by means of exer-
cise or labour, that vigour which belongs to the
Indians, or to mankind in their first stage of civi-
lization.

The efficacy of these means of curing consump-
tion will appear, when we inquire into the relative
merit of the several remedies which have been
used by physicians in this disease.

I shall not produce among these remedies the
numerous receipts for syrups, boluses, electuaries,
decoctions, infusions, pills, medicated waters, pow-
ders, draughts, mixtures, and diet-drinks, which
have -so long and so steadily been used in this
disease ; nor shall I mention as a remedy, the best
accommodated diet, submitted to with the most
patient self-denial ; for not one of them all, without
the aid of exercise, has ever, I believe, cured a
single consumption.

vol. i-. 2 c

202 THOUGHTS ON THE CONSUMPTION.

1. Sea-voyages have cured consumptions;
but it has been only when they have been so long,
or so frequent, as to substitute the long continu-
ance of gentle, to violent degrees of exercise of a
shorter duration, or where they have been accom-
panied by some degree of the labour and care of
navigating the ship.

2. A change of c l i m a t e has often been pre-
scribed for the cure of consumptions, but I do not
recollect an instance of its having succeeded, ex-
cept when it has been accompanied by exercise, as
in travelling, or by some active laborious pursuit.

Doctor Gordon of Madeira, ascribes the ineffi-
cacy of the air of Madeira in the consumption, in
part to the difficulty patients find of using exercise
in carriages, or even on horseback, from the bad-
ness of the roads in that island.

3. Journies have often performed cures in the
consumption, but it has been chiefly when they
have been long, and accompanied by difficulties
which have roused and invigorated the powers of
the mind and body.

4. Vomits and nauseating medicines have
been much celebrated for the cure of consump

THOUGHTS ON THE CONSUMPTION. 203

tions. These, by procuring a temporary determi-
nation to the surface of the body, so far lessen the
pain and cough, as to enable patients to use pro-
fitable exercise. Where this has not accompanied
or succeeded the exhibition of vomits, I believe
they have seldom afforded any permanent relief.

5. Blood-letting has often relieved con-
sumptions ; but it has been only by removing the
troublesome symptoms of inflammatory diathesis,
and thereby enabling the patients to use exercise,
or labour, with advantage.

6. Vegetable bitters and some of the sti-
mulating gums have in some instances afforded
relief in consumptions ; but they have done so
only in those cases where there wras great debility,
accompanied by a total absence of inflammatory
diathesis. They have most probably acted by
their tonic qualities, as substitutes for labour and
exercise.

7. A plentiful and regular perspira-
tion, excited by means of a flannel shirt, worn
next to the skin, or by means of a stove-room, or
by a warm climate, has in many instances prolonged
life in consumptive habits ; but all these remedies
have acted as palliatives only, and thereby hav^

£04 THOUGHTS ON THE CONSUMPTION.

enabled the consumptive patients to enjoy the more
beneficial effects of exercise.

8. Blisters, setons, and issues, by deter-
mining the perspirable matter from the lungs to
the surface of the body, lessen pain and cough,
and thereby prepare die system for the more salu-
tary effects of exercise.

9. The effects of swinging upon the pulse and
respiration, leave us no room to doubt of its being
a tonic remedy, and therefore a safe and agreeable
substitute for exercise.

From all these facts it is evident, that the reme-
dies for consumptions must be sought for in those
exercises and employments "which ghe the greatest
vigour to the constitution. And here I am happy
in being able to produce several facts which de-
monstrate the safety and certainty of this method
of cure.

During the late war, I saw three instances of
persons in confirmed consumptions, who were per-
fectly cured by the hardships of a military life.
They had been my patients previously to their
entering into the army. Besides these, I have
heard of four well-attested cases of similar reco-

THOUGHTS ON THE CONSUMPTION. 205

veries from nearly the same remedies. One of
these was the son of a farmer in New- Jersey, who
was sent to sea as the last resource for a consump-
tion. Soon after he left the American shore, he
was taken by a British cruiser, and compelled to
share in all the duties and hardships of a common
sailor. After serving in this capacity for twenty-
two months, he made his escape, and landed at
Boston, from whence he travelled on foot to his
father's house (nearly four hundred miles), where
he arrived in perfect health.

Doctor Way of Wilmington informed me, that
a certain Abner Cloud, who was reduced so low
by a pulmonary consumption as to be beyond all
relief from medicine, was so much relieved by
sleeping in the open air, and by the usual toils of
building a hut, and improving a farm, in the un-
settled parts of a new country in Pennsylvania,
that he thought him in a fair way of a perfect re-
covery.

Doctor Latimer of Wilmington had been long
afflicted with a cough and an occasional haemop-
tysis. He entered into the American army as a
surgeon, and served in that capacity till near the
end of the war ; during which time he was per-
fectly free from all pulmonary disease. The

206 THOUGHTS ON THE CONSUMPTION.

spitting of blood returned soon after he settled in
private practice. To remedy this complaint, he
had recourse to a low diet, but finding it ineffec-
tual, he partook liberally of the usual diet of healthy
men, and he now enjoys a perfect exemption from
it.

It would be very easy to add many other cases,
in which labour, the employments of agriculture,
and a life of hardship by sea and land, have pre-
vented, relieved, or cured, not only the consump-
tion, but pulmonary diseases of all kinds.

To the cases that have been mentioned, I shall
add only one more, which was communicated to
me by the venerable Doctor Franklin, whose con-
versation at all times conveyed instruction, and not
less in medicine than upon other subjects.- In tra-
velling, many years ago, through New- England,
the doctor overtook the post-rider ; and after some
inquiries into the history of his life, he informed
him that he was bred a shoemaker ; that his con-
finement, and other circumstances, had brought on
a consumption, for which he was ordered by a
physician to ride on horseback. Finding this
mode of exercise too expensive, he made interest,
upon the death of an old post-rider, to succeed to
his appointment, in which he perfectly recovered

THOUGHTS ON THE CONSUMPTION. 207

his health in two years. After this he returned to
his old trade, upon which his consumption return-
ed. He again mounted his horse, and rode post
in all seasons and weathers, between New- York
and Connecticut river (about 140 miles), in which
emplo)Tment he continued upwards of thirty years,
in perfect health.

i These facts, I hope, are sufficient to establish
the advantages of restoring the original vigour of
the constitution, in every attempt to effect a radical
cure of consumption.

But how shall these remedies be applied in the
time of peace, or in a country where the want of
woods, and brooks without bridges, forbid the at-
tainment of the laborious pleasures of the Indian
mode of hunting ; or where the universal extent of
civilization does not admit of our advising the toils
of a new settlement, and improvements upon bare
creation ? Under these circumstances, I conceive
substitutes may be obtained for each of them,
nearly of equal efficacy, and attainable with much
less trouble.

1. Doctor Sydenham pronounced riding on
horseback, to be as certain a cure for consumptions
as bark is for an intermitting fever. I have no

208 THOUGHTS ON THE CONSUMPTION".

more doubt of the truth of this assertion, than I
have that inflammatory fevers are now less frequent
in London than thev were in the time of Doctor
Sydenham. If riding on horseback in consump-
tions has ceased to be a remedy in Britain, the
fault is in the patient, and not in the remedy. " It
" is a sign that the stomach requires milk (says
" Doctor Cadogan), when it cannot bear it." In
like manner, the inability of the patient to bear this
manly and wholesome exercise, serves only to de-
monstrate the necessity and advantages of it. I
suspect the same objections to this exercise which
have been made in Britain, will not occur in the
United States of America ; for the Americans,
with respect to the symptoms and degrees of epi-
demic and chronic diseases, appear to be nearly in
the same state that the inhabitants of England were
in the seventeenth century. We find, in propor.
tion to the decline of the vigour of the body, that
many occasional causes produce fever and inflam-
mation, which would not have done it a hundred
years ago.

2. The laborious employments of agriculture)
if steadily pursued, and accompanied at the same
time by the simple, but wholesome diet of a farm-
house, and a hard bed, would probably afford a

THOUGHTS ON THE CONSUMPTION. 209

good substitute for the toils of a savage or military
life.

,3. Such occupations or professions as require
constant labour or exercise in the open air, in all
kinds of weather, may easily be chosen for a young
man who, either from hereditary predisposition, or
an accidental affection of the lungs, is in danger of
falling into a consumption. In this we should
imitate the advice given by some wise men, always
to prefer those professions for our sons, which are
the least favourable to the corrupt inclinations of
their hearts. For example, where an undue pas-
sion for money, or a crafty disposition, discover
themselves in early life, we are directed to oppose
them by the less profitable and more disinterested
professions of divinity or physic, rather than che-
rish them by trade, or the practice of the law.
Agreeably to this analogy, weakly children should
be trained to the laborious, and the robust, to the
sedentary occupations. From a neglect of this
practice, many hundred apprentices to taylors,
shoemakers, conveyancers, watchmakers, silver-
smiths, and mantua- makers, perish every year by
consumptions.

4. There is a case recorded by Dr. Smollet, of
the efficacy of the cold bath in a consumption ; and
vol. i. 2d

210 THOUGHTS ON THE CONSUMPTION.

I have heard of its having been used with success,
in the case of a negro man, in one of the West-
India islands. To render this remedy useful, or
even safe, it will be necessary to join it with la-
bour, or to use it in degrees that shall prevent the
alternation of the system with vigour and debility ;
for I take the cure of consumption ultimately to de-
pend upon the simple and constant action of tonic
remedies. It is to be lamented that it often requires
so much time, or such remedies to remove the in-
flammatory diathesis, which attends the first stage
of consumption, as to reduce the patient too low
to make use of those tonic remedies afterwards,
which would effect a radical cure.

If it were possible to graduate the tone of the
system by means of a scale, I would add, that to
cure consumption, the system should be raised to
the highest degree of this scale. Nothing short of
an equilibrium of tone, or a free and vigorous ac-
tion of every muscle and viscus in the body, will
fully come up to a radical cure of this disease.

In regulating the diet of consumptive patients,
I conceive it to be as necessary to feel the pulse,
as it is in determining when and in what quantity
to draw blood. Where inflammatory diathesis
prevails, a vegetable diet is certainly proper ; but

THOUGHTS ON THE CONSUMPTION. 211

where the patient has escaped, or passed this stage
of the disease, I believe a vegetable diet alone to
be injurious ; and am sure a moderate quantity of
animal food may be taken with advantage.

The presence or absence of this inflammatory
diathesis, furnishes the indications for administering
or refraining from the use of the bark and balsamic
medicines. With all the testimonies of their hav-
ing done mischief, many of which I could produce,
I have known several cases in which they have
been given with obvious advantage ; but it was
only when there was a total absence of inflammatory
diathesis.

Perhaps the remedies I have recommended, and
the opinions I have delivered, may derive some
support from attending to the analogy of ulcers on
the legs, and in other parts of the body. The first
of these occur chiefly in habits debilitated by spi-
ritous liquors, and the last frequently in habits de-
bilitated by the scrophula. In curing these dis-
eases, it is in vain to depend upon internal or ex-
ternal medicines. The whole system must be
strengthened, or we do nothing ; and this is to be
effected only by exercise and a generous diet.

212 THOUGHTS ON THE CONSUMPTION.

In relating the facts that are contained in this
inquiry, I wish I could have avoided reasoning upon
them ; especially as I am confident of the certainty
of the facts, and somewhat doubtful of the truth of
my reasonings.

I shall only add, that if the cure of consumptions
should at last be effected by remedies in every re-
spect the opposites of those palliatives which are
now fashionable and universal, no more will happen
than what we have already seen in the tetanus, the
small-pox, aiKjfcthe management of fractured limbs.

Should this be the case, we shall not be sur-
prised to hear of physicians, instead of prescribing
any one, or all of the medicines formerly enume-
rated for consumptions, ordering their patients to
exchange the amusements, or indolence of a city,
for the toils of a country life ; of their advising
farmers to exchange their plentiful tables, and com-
fortable fire-sides, for the scanty but solid subsist-
ence, and midnight exposure of the herdsman ; or
of their recommending, not so much the exercise
of a passive sea voyage, as the active labours and
dangers of a common sailor. Nor should it sur-
prise us, after what we have seen, to hear patients
relate the pleasant adventures of their excursions

THOUGHTS ON THE CONSUMPTION, 213

or labours, in quest of their recovery from this dis-
ease, any more than it does now to see a strong or
well- shaped limb that has been broken ; or to hear
a man talk of his studies, or pleasures, during the
time of his being inoculated and attended for the
small-pox.

I will not venture to assert, that there does not
exist a medicine which shall supply, at least in
some degree, the place of the labour or exercises,
whose usefulness in consumptions has been esta-
blished by the facts that have been mentioned.
Many instances of the analogous effects of medi-
cines, and of exercise upon the human body, for-
bid the supposition. If there does exist in nature
such a medicine, I am disposed to believe it will
be found in the class of tonics. If this should
be the case, I conceive its strength, or its dose,
must far exceed the present state of our knowledge
or practice, with respect to the efficacy or dose of
tonic medicines.

I except the disease, which arises from recent
abscesses in the lungs, from the general observa-
tion which has been made, respecting the ineffi-
cacy of the remedies that were formerly enume-
rated for the cure of consumptions without labour

214 THOUGHTS ON THE CONSUMPTION.

or exercise. These abscesses often occur without
being preceded by general debility, or accompanied
by a consumptive diathesis, and are frequently
cured by nature, or by very simple medicines.

OBSERVATIONS UPON WORMS

IN THE

ALIMENTARY CANAL,

AND UPON

ANTHELMINTIC MEDICINES.

OBSERVATIONS, &c.

WITH great diffidence I venture to lay be-
fore the public my opinions upon worms : nor
should I have presumed to do it, had I not enter-
tained a hope of thereby exciting further inquiries
upon this subject.

When we consider how universally worms are
found in all young animals, and how frequently
they exist in the human body, without producing
disease of any kind, it is natural to conclude, that
they serve some useful and necessary purposes in
the animal economy. Do they consume the super-
fluous aliment which all young animals are dis-
posed to take, before they have been taught, by ex-
perience or reason, the bad consequences which
arise from it ? It is no objection to this opinion,
that worms are unknown in the human body in

voi,. i. 2 E

218 OBSERVATIONS UPON WORMS

some countries. The laws of nature are diversi-
fied, and often suspended under peculiar circum-
stances in many cases, where the departure from
uniformity is still more unaccountable, than in the
present instance. Do worms produce diseases
from an excess in their number, and an error in
their place, in the same manner that blood, bile,
and air produce diseases from an error in their
place, or from excess in their quantities ? Before
these questions are decided, I shall mention a few
facts which have been the result of my own obser-
vations upon this subject.

1. In many instances, I have seen worms dis-
charged in the small-pox and measles, from chil-
dren who were in perfect health previously to their
being attacked by those diseases, and who never
before discovered a single symptom of worms. I
shall say nothing here of the swarms of worms
which are discharged in fevers of all kinds, until I
attempt to prove that an idiopathic fever is never
produced by worms.

2. Nine out of ten of the cases which I have
seen of worms, have been in children of the gross-
est habits and most vigorous constitutions. This
is more especially the case where the worms are
dislodged by the small-pox and measles. Doctor

AND ANTHELMINTIC MEDICINES. 219

Capelle of Wilmington, in a letter which I received
from him, informed me, that in the livers of six-
teen, out of eighteen rats which he dissected, he
found a number of the tasnia worms. The rats
were fat, and appeared in other respects to have
been in perfect health. The two rats in which he
found no worms, he says, " were very lean, and
" their livers smaller in proportion than the others."

3. In weakly children, I have often known the
most powerful anthelmintics given without bring-
ing away a single worm. If these medicines have
afforded any relief, it has been by their tonic qua-
lity. From this fact, is it not probable — the con-
jecture, I am afraid, is too bold, but I will risk it:
— is it not probable, I say, that children are some-
times disordered from the want of worms ? Per-
haps the tonic medicines which have been men-
tioned, render the bowels a more quiet and com-
fortable asylum for them, and thereby provide the
system with the means of obviating the effects of
crapulas, to which all children are disposed. It is
in this way that nature, in many instances, cures
evil by evil. I confine the salutary office of worms
only to that species of them which is known by
the name of the round worm, and which occurs
most frequently in children.

220 OBSERVATIONS UPON WORMS

Is there any such disease as an idiopathic worm-
fever ? The Indians in this country say there is
not, and ascribe the discharge of worms to a fever,
and not a fever to the worms*.

By adopting this opinion, I am aware that I
contradict the observations of many eminent and
respectable physicians.

Doctor Huxham describes an epidemic pleurisy,
in the month of March, in the year 1740, which
he supposes was produced by his patients feeding
upon some corn that had been injured by the rain
the August beforef . He likewise mentions that a
number of people, and those too of the elderly
sort J, were afflicted at one time with worms, in
the month of April, in the year 1743.

Lieutade gives an account of an epidemic wor^
feyer from Velchius, an Italian physician % ; ancj
Sauvages describes, from Vandermond^ an epide-
mic dysentery from worms, which yielded finally
only to worm medicines^. Sly John Pringle, mid

* See the Inquiry into the Diseases of the Indi--
f Vol. II. of his Epidemics, p. 56. '

\ P. 136- IJ Vol. I,p-

$ Vol. II. p. 329. ' 76#

AND ANTHELMINTIC MEDICINES. 221

Doctor Monro, likewise frequently mention worms
as accompanying the dysentery and remitting fever,
and recommend the use of calomel as an antidote
to them.

I grant that worms appear more frequently in
some epidemic diseases than in others, and oftener
in some years than in others. But may not the
same heat, moisture, art** diet which produced the
diseases, aav£ produced the worms ? And may not
uieir discharge from the bowels have been occa-
sioned in those epidemics, as in the small-pox and
measles, by the increased heat of the body, by the
want of nourishment, or by an anthelmintic quality
being accidentally combined with some of the me-
dicines that are usually given in fevers ?

In answer to this, we are told that we often see
the crisis of a fever brought on by the discharge
of worms from the bowels by means of a purge,
or by an anthelmintic medicine. Whenever this
is the case, I believe it is occasioned by offending
bile being dislodged by means of the purge, at the
same time with the worms, or by the anthelmintic
medicine (if not a purge) having been given on, or
near one of the usual critical days of the fever.
What makes the latter supposition probable is,
that worms are seldom suspected in the beginning

222 OBSERVATIONS UPON WORMS

of fevers, and anthelmintic medicines seldom given,
till every other remedy has failed of success ; and
this generally happens about the usual time in
which fevers terminate in life or death.

It is very remarkable, that since the discovery
and description of the hydrocephalus interims, we
hear and read much less than formerly of worm-
fevers. I suspect that disease of the brain has laid
the foundation for the principal part of the cases of
worm-fevers which are upon record in books of
medicine. I grant that worms sometimes increase
the danger from fevers, and often confound the
diagnosis and prognosis of them, by a number of
new and anomalous symptoms. But here we see
nothing more than that complication of symptoms
which often occurs in diseases of a very different
and opposite nature.

Having rejected worms as the cause of fevers, I
proceed to remark, that the diseases most com-
monly produced by them, belong to Dr. Cullen's
class of neuroses. And here I might add, that
there is scarcely a disease, or a symptom of a dis-
ease, belonging to this class, which is not produced
by worms. It would be only publishing extracts
from books, to describe them.

AND ANTHELMINTIC MEDICINES. 223

The chronic and nervous diseases of children,
which are so numerous and frequently fatal, are, I
believe, frequently occasioned by worms. There
is no great danger, therefore, of doing mischief, by
prescribing anthelmintic medicines in all our first
attempts to cure their chronic and nervous diseases.

I have been much gratified by finding myself
supported in the above theory of worm- fevers, by
the late Dr. William Hunter, and by Dr. Butter,
in his excellent treatise upon the infantile remitting
fever.

I have taken great pains to find out, whether
the presence of the different species of worms might
not be discovered by certain peculiar symptoms ;
but all to no purpose. I once attended a girl of
twelve years of age in a fever, who discharged four
yards of a taenia, and who was so far from having
discovered any peculiar symptom of this species
of worms, that she had never complained of any
other indisposition, than now and then a slight
pain in the stomach, which often occurs in young
girls from a sedentary life, or from errors in their
diet. I beg leave to add further, that there is not
a symptom which has been said to indicate the
presence of worms of any kind, as the cause of a
disease, that has not deceived me ; and none oftener

224 OBSERVATIONS UPON WORMS'

than the one that has been so much depended up-
on, viz. the picking of the nose. A discharge of
worms from the bowels, is, perhaps, the only symp-
tom that is pathognomonic of their presence in
the intestines.

I shall now make a few remarks upon antheU
mintic remedies.

But I shall first give an account of some experi-
ments which I made in the year 1771, upon the
common earth-worm, in order to ascertain the an-
thelmintic virtues of a variety of substances. I
made choice of the earth-worm for this purpose,
as it is, according to naturalists, nearly the same
in its structure, manner of subsistence, and mode
of propagating its species, with the round worm of
the human body.

In the first column I shall set down, under dis-
tinct heads, the substances in which worms were
placed ; and in the second and third columns the
time of their death, from the action of these sub*
stances upon them.

AND ANTHELMINTIC MEDICINES.

225

I. Bitter and astringent

SUBSTANCES.

Watery infusion of aloes

of rhubarb

of Peruvian bark

II. Purges.

Watery infusion of jalap

, , bear's-foot

gamboge

III. Salts.

1. Acids.
Vinegar
Lime juice
Diluted nitrous acid

2. Alkali.

A watery solution of salt of
tartar

3. Neutral Salts.

In a watery solution of com-
mon salt

of nitre

of sal diuretic

of sal ammoniac

■ of common salt and su-
gar.

4. Earthy and metallic salts.
In a watery solution of Epsom

salt

of rock alum

of corrosive sublimate

of calomel

of turpeth mineral

of sugar of lead

of green vitriol

of blue vitriol

of white vitriol

VOL. I. 2

Hours.

2
1
1

Minutes.

48
30
30

17

\\ convulsed.

>i

2 convulsed, throw-
ing up a mucus
on the surface of
the water.
1 convulsed,
ditto,
ditto.

'l

4

- I

151
10

1^ convulsed.
49

1 convulsed.

3

1
10
30

226

OBSERVATIONS UPON WORMS

IV. Metals.
Filings of steel
Filings of tin

V. Calcareous earth.
Chalk

VI. Narcotic substances.
Watery infusion of opium

of Carolina pink-root

of tobacco

VII. Essential oil?
Oil of wormwood

— of mint

— of caraway seed

— of amber

— of anniseed

— of turpentine

VIII. Arsenic.

A watery solution of white ar-
senic

IX. Fermented liquors.
In Madeira wine
Claret

X. Distilled spirit.
Common rum

XI. The fresh juices of ripe

fruits.
The juice of red cherries

of black do.

of red currants

■ ■ ■ ■ of gooseberries

of whortleberries

of blackberries

■ of raspberries

of plums

— — — ■ of peaches

Hours.

2

Minutes.

2i

— r

1 1 J convulsed

—

33

"W"

14

_

3 convulsed.

—

3

—

3

—

H

6

near

2

—

3 convulsed.

•—

10

1 convulsed.

4

5

H
H

12

r
4

13

25

AND ANTHELMINTIC MEDICINES. 227

The juice of water-melons, no jHours.
effect

XII. Saccharine substances.
Honey
Molasses
Brown sugar
Manna

XIII. In aromatic substances.
Camphor
Pimento
Black pepper

XIV. Foetid substances
Juice of onions
Watery infusion of assafoetida
Santonicum, or worm

seed

XV. Miscellaneous substan-
ces.
Sulphur mixed with oil
jEthiops mineral
Sulphur
Solution of gunpowder

^— - of soap

Oxymel of squills
Sweet oil

2
2

2

Minutes.

7
7

30

31

45

27

4
19

°*
30

In the application of these experiments to the
human body, an allowance must always be made
for the alteration which the several anthelmintic
substances that have been mentioned, may undergo
from mixture and diffusion in the stomach and
bowels.

In order to derive any benefit from these expe-

228 OBSERVATIONS UPON WORMS

riments, as well as from the observations that have
been made upon anthelmintic medicines, it will be
necessaiy to divide them into such as act,

1. Mechanically,

2. Chemically upon worms ; and,

3. Into those which possess a power composed
of chemical and mechanical qualities.

1. The mechanical medicines act indirectly and
directly upon the worms.

Those which act indirectly are, vomits, purges,
bitter and astringent substances, particularly aloes,
rhubarb, bark, bear's-foot, and worm-seed. Sweet
oil acts indirectly and very feebly upon worms. It
was introduced into medicine from its efficacy in
destroying the botts in horses ; but the worms
which infest the human bowels, are of a different
nature, and possess very different organs of life
from those which are found in the stomach of a
horse.

Those mechanical medicines which act directly
upon the worms, are cowhage* and powder of tin.

* Dolichos Pruriens, of Linnxus.

AND ANTHELMINTIC MEDICINES. 229

The last of these medicines has been supposed to
act chemically upon the worms, from the arsenic
which adheres to it ; but from the length of time
a worm lived in a solution of white arsenic, it is
probable the tin acts altogether mechanically upon
them.

2. The medicines which act chemically upon
worms, appear, from our experiments, to be very-
numerous.

Nature has wisely guarded children against the
morbid effects of worms, by implanting in them
an early appetite for common salt, ripe fruits, and
saccharine substances ; all of which appeal' to be
among the most speedy and effectual poisons for
worms.

Let it not be said, that nature here counteracts
her own purposes. Her conduct in this business
is conformable to many of her operations in the
human body, as well as throughout all her works.
The bile is a necessary part of the animal fluids,
and yet an appetite for ripe fruits seems to be im-
planted chiefly to obviate the consequences of its
excess, or acrimony, in the summer and autumnal
months.

230 OBSERVATIONS UPON WORMS

The use of common salt as an anthelmintic me-
dicine, is both ancient and universal. Celsus re-
commends it. In Ireland it is a common practice
to feed children, who are afflicted by worms, for a
week or two upon a salt- sea weed, and when the
bowels are well charged with it, to give a purge of
wort in order to carry off the worms, after they are
debilitated by the salt diet.

I have administered many pounds of common
salt coloured with cochineal, in doses of half a
drachm, upon an empty stomach in the morning,
with great success in destroying worms.

Ever since I observed the effects of sugar and
other sweet substances upon worms, I have recom-
mended the liberal use of all of them in the diet of
children, with the happiest effects. The sweet sub-
stances probably act in preventing the diseases from
worms in the stomach only, into which they often
insinuate themselves, especially in the morning.
When we wish to dislodge worms from the bowels
by sugar or molasses, we must give these sub-
stances in large quantities, so that they may escape
in part the action of the stomach upon them.

I can say nothing from my own experience of
the efficacy of the mineral salts, composed of cop-

AND ANTHELMINTIC MEDICINES. 231

per, iron, and zinc, combined with vitriolic acid,
in destroying worms in the bowels. Nor have I
ever used the corrosive sublimate in small doses as
an anthelmintic.

I have heard of well-attested cases of the efficacy
of the oil of turpentine in destroying worms.

The expressed juices of onions and of garlic are
very common remedies for worms. From one of
the experiments, it appears that the onion juice
possesses strong anthelmintic virtues.

I have often prescribed a tea-spoonful of gun-
powder in the morning upon an empty stomach,
with obvious advantage. The active medicine
here is probably the nitre.

I have found a syrup made of the bark of the
Jamaica cabbage-tree*, to be a powerful as well as
a most agreeable anthelmintic medicine. It some-
times purges and vomits, but its good effects may
be obtained without giving it in such doses as to
produce these evacuations.

* Geoffrea, of Lirmreus.

232 OBSERVATIONS UPON WORMS

There is not a more certain anthelmintic than
Carolina pink-root*. But as there have been in-
stances of death having followed excessive doses of
it, imprudently administered, and as children are
often affected by giddiness, stupor, and a redness
and pain in the eyes after taking it, I acknowledge
that I have generally preferred to it, less certain,
but more safe medicines for destroying worms.

3. Of the medicines whose action is compound-
ed of mechanical and chemical qualities, calomel,
jalap, and the powder of steel, are the principal.

Calomel, in order to be effectual, must be given
in large doses. It is a safe and powerful anthel-
mintic. Combined with jalap, it often brings
away worms when given for other purposes.

Of all the medicines that I have administered,
I know of none more safe and certain than the
simple preparations of iron, whether they be given
in the form of steel-filings or of the rust of iron.
If ever they fail of success, it is because they are
given in too small doses. I generally prescribe
from five to thirty grains every morning, to chil-
dren between one year, and ten years old ; and I

* Spigelia Marylandica, of Linnseus.

AND ANTHELMINTIC MEDICINES. 233

have been taught by an old sea-captain, who was
cured of a taenia by this medicine, to give from
two drachms to half an ounce of it, every morning,
for three or four days, not only with safety, but
with success.

I shall conclude this essay with the following
remarks :

1. Where the action of medicines upon worms
in the bowels does not agree exactly with their
action upon the earth-worms in the experiments
that have been related, it must be ascribed to the
medicines being more or less altered by the action
of the stomach upon them. I conceive that the
superior anthelmintic qualities of pink-root, steel-
filings, and calomel (all of which acted but slowly
upon the earth-worms compared with many other
substances) are in a great degree occasioned by
their escaping the digestive powers unchanged, and
acting in a concentrated state upon the worms.

2. In fevers attended with anomalous symptoms,
which are supposed to arise from worms, I have
constantly refused to yield to the solicitations of
my patients, to abandon the indications of cure in
the fever, and to pursue worms as the principal
cause of the disease. While I have adhered stea-

vol. i. 2 G

234 OBSERVATIONS UPON WORMS, &C.

dily to the usual remedies for the different states of
fever, in all their stages, I have at the same time
blended those remedies occasionally with anthel-
mintic medicines. In this I have imitated the
practice of physicians in many other diseases, in
which troublesome and dangerous symptoms are
pursued, without seducing the attention from the
original disease. The anthelmintic medicines pre-
scribed in these cases, should not be the rust of
iron, and common salt, which are so very useful
in chronic diseases from worms, but calomel and
jalap, and such other medicines as aid in the cure
of fevers.

AN ACCOUNT

OF THE

EXTERNAL USE OF ARSENIC,

IN THE

CURE OF CANCERS.

AN ACCOUNT, &'c,

A FEW years ago, a certain Doctor Hugh
Martin, a surgeon of one of the Pennsylvania regi-
ments stationed at Pittsburg, during the latter part
of the late war, came to this city, and advertised
to cure cancers with a medicine which he said he
had discovered in the woods, in the neighbourhood
of the garrison. As Dr. Martin had once been
my pupil, I took the liberty of waiting upon him,
and asked him some questions respecting his dis-
covery. His answers were calculated to make me
believe, that his medicine was of a vegetable na-
ture, and that it was originally an Indian remedy.
He showed me some of the medicine, which ap-
peared to be the powder of a well-dried root of
some kind. Anxious to see the success of this
medicine in cancerous sores, I prevailed upon the
doctor to admit me to see him apply it in two or

238 ACCOUNT OF THE USE OF ARSENIC

three cases. I observed, in some instances, he
applied a powder to the parts affected, and in others
only touched them with a feather dipped in a liquid
which had a white sediment, and which he made
me believe was the vegetable root diffused in
water. It gave me great pleasure to witness the
efficacy of the doctor's applications. In several
cancerous ulcers, the cures he performed were
complete. Where the cancers were much con-
nected with the lymphatic system, or accompanied
with a scrophulous habit of body, his medicine
always failed, and, in some instances, did evident
mischief.

Anxious to discover a medicine that promised
relief in even a few cases of cancers, and sup-
posing that all the caustic vegetables were nearly
alike, I applied the phytolacca or poke-root, the
stramonium, the arum, and one or two others, to
foul ulcers, in hopes of seeing the same effects
from them which I had seen from Doctor Mar-
tin's powder; but in these I was disappointed.
They gave some pain, but performed no cures.
At length I was furnished by a gentleman from
Pittsburg with a powder which I had no doubt,
from a variety of circumstances, was of the same
kind as that used by Dr. Martin. I applied it to
a fungous ulcer, but without producing the de-

IN THE CURE OF CANCERS. 239

grees of pain, inflammation, or discharge, which
I had been accustomed to see from the application
of Dr. Martin's powder. After this, I should
have suspected that the powder was not a simple
root, had not the doctor continued upon all occa-
sions to assure me, that it was wholly a vegetable
preparation.

In the beginning of the year 1784, the doctor
died, and it was generally believed that his medi-
cine had died with him. A few weeks after his
death I procured, from one of his administrators,
a few ounces of the doctor's powder, partly with
a view of applying it to a cancerous sore which
then offered, and partly with a view of examining
it more minutely than I had been able to do dur-
ing the doctor's life. Upon throwing the pow-
der, which was of a brown colour, upon a piece
of white paper, I perceived distinctly a number of
white particles scattered through it. I suspected
at first that they were corrosive sublimate, but the
usual tests of that metallic salt soon convinced me,
that I was mistaken. Recollecting that arsenic
was the basis of most of the celebrated cancer
powders that have been used in the world, I had
recourse to the tests for detecting it. Upon sprink-
ling a small quantity of the powder upon some
coals of fire, it emitted the garlick smell so per-

240 ACCOUNT OF THE USE OF ARSENIC

ceptibly as to be known by several persons whom
I called into the room where I made the experi-
ment, and who knew nothing of the object of my
inquiries. After this, with some difficulty I picked
out about three or four grains of the white pow-
der, and bound them between two pieces of cop-
per, which I threw into the fire. After the cop-
per pieces became red hot, I took them out of
the fire, and when they had cooled, discovered an
evident whiteness imparted to both of them. One
of the pieces afterwards looked like dull silver.
These two tests have generally been thought suffi-
cient to distinguish the presence of arsenic in any
bodies ; but I made use of a third, which has
lately been communicated to the world by Mr.
Bergman, and which is supposed to be in all cases
infallible.

I infused a small quantity of the powder in a
solution of a vegetable alkali in water for a few
hours, and then poured it upon a solution of blue
vitriol in water. The colour of the vitriol was
immediately changed to a beautiful green, and af-
terwards precipitated.

I shall close this paper with a few remarks upon
this powder, and upon the cure of cancers and foul
ulcers of all kinds.

IN THE CURE OF CANCERS. 241

1. The use of caustics in cancers and foul ul-
cers is very ancient, and universal. But I believe
arsenic to be the most efficacious of any that has
ever been used. It is the basis of Plunket's and
probably of Guy's well-known cancer powders.
The great art of applying it successfully, is to di-
lute and mix it in such a manner as to mitigate the
violence of its action. Doctor Martin's composi-
tion was happily calculated for this purpose. It
gave less pain than the common or lunar caustic.
It excited a moderate inflammation, which sepa-
rated the morbid from the sound parts, and pro-
moted a plentiful afflux of humours to the sore
during its application. It seldom produced an
escar ; hence it insinuated itself into the deepest
recesses of the cancers, and frequently separated
those fibres in an unbroken state, which are gene-
rally called the roots of the cancer. Upon this
account, I think, in some ulcerated cancers it is to
be preferred to the knife. It has no action upon the
sound skin. This Doctor Hall proved, by confin-
ing a small quantity of it upon his arm for many
hours. In those cases where Doctor Martin used
it to extract cancerous or schirrous tumours that
were not ulcerated, I have reason to believe that
he always broke the skin with Spanish flies.

VOL. I. 2 H

242 ACCOUNT OF THE USE OF ARSENIC

2. The arsenic used by the doctor was the pure
white arsenic. I should suppose from the exami-
nation I made of the powder with the eye, that
the proportion of arsenic to the vegetable powder,
could not be more than one-fortieth part of the
whole compound. I have reason to think that the
doctor employed different vegetable substances at
different times. The vegetable matter with which
the arsenic was combined in the powder which I
used in my experiments, was probably nothing
more than the powder of the root and berries of the
solanum lethale, or deadly nightshade. As the
principal, and perhaps the only design of the vege-
table addition was to blunt the activitv of the arse-
nic, I should suppose that the same proportion of
common wheat flour as the doctor used of his
caustic vegetables, would answer nearly the same
purpose. In those cases where the doctor applied
a feather dipped in a liquid to the sore of his pa-
tient, I have no doubt but his phial contained
nothing but a weak solution of arsenic in water.
This is no new method of applying arsenic to foul
ulcers. Doctor Way of Wilmington has spoken
in the highest terms to me of a wash for foulnesses
on the skin, as well as old ulcers, prepared by boil-
ing an ounce of white arsenic in two quarts of
water to three pints, and applying it once or twice
a day.

IN THE CURE OF CANCERS. 243

3. I mentioned, formerly, that Doctor Martin
was often unsuccessful in the application of his
powder. This was occasioned by his using it in-
discriminately in all cases. In schirrous and can-
cerous tumours, the knife should always be pre-
ferred to the caustic. In cancerous ulcers attended
with a scrophulous or a bad habit of body, such
particularly as have their seat in the neck, in the
breasts of females, and in the axillary glands, it
can only protract the patient's misery. Most of
the cancerous sores cured by Doctor Martin were
seated on the nose, or cheeks, or upon the surface
or extremities of the body. It remains yet to dis-
cover a cure for cancers that taint the fluids, or
infect the whole lymphatic system. This cure I
apprehend must be sought for in diet, or in the
long use of some internal medicine.

To pronounce a disease incurable, is often to
render it so. The intermitting fever, if left to
itself, would probably prove frequently, and per-
haps more speedily fatal than cancers. And as
cancerous tumours and sores are often neglected,
or treated improperly by injudicious people, from
an apprehension that they are incurable (to which
the frequent advice of physicians " to let them
" alone," has no doubt contributed), perhaps the
introduction of arsenic into regular practice as a

244 ACCOUNT OF THE USE OF ARSENIC.

remedy for cancers, may invite to a more early ap-
plication to physicians, and thereby prevent the
deplorable cases that have been mentioned, which
are often rendered so by delay or unskilful ma-
nagement.

4. It is not in cancerous sores only that Doctor
Martin's powder has been found to do service. In
sores of all kinds, and from a variety of causes,
where they have been attended with fungous flesh
or callous edges, I have used the doctor's powder
with advantage.

I flatter myself that I shall be excused in giving
this detail of a quack medicine, when we reflect
that it was from die inventions and temerity of
quacks, that physicians have derived some of their
most active and most useful medicines.

OBSERVATIONS

UPON

THE TETANUS.

OBSERVATIONS, &c.

FOR a history of the different names and
symptoms of this disease, I beg leave to refer the
reader to practical books, particularly to Doctor
Cullen's First Lines. My only design in this in-
quiry, is to deliver such a theory of the disease, as
may lead to a new and successful use of old and
common remedies for it.

All the remote and predisposing causes of the
tetanus act by inducing preternatural debility, and
irritability in the muscular parts of the body. In
many cases, the remote causes act alone, but they
more frequently require the co-operation of an ex-
citing cause. I shall briefly enumerate, without
discriminating them, or pointing out when they
act singly, or when in conjunction with each other.

248 OBSERVATIONS ON THE TETANUS.

I. Wounds on different parts of the body are
the most frequent causes of this disease. It was
formerly supposed it was the effect only of a wound,
which partially divided a tendon, or a nerve ; but
we now know it is often the consequence of laesions
which affect the body in a superficial manner. The
following is a list of such wounds and laesions as
have been known to induce the disease :

1. Wounds in the soles of the feet, in the
palms of the hands, and under the nails, by means
of nails or splinters of wood.

2. Amputations, and fractures of limbs.

3. Gun-shot wounds.

4. Venesection.

5. The extraction of a tooth, and the insertion,
of new teeth.

6. The extirpation of a schirrus.

7. Castration.

8. A wound on the tongue.

OBSERVATIONS ON THE TETANUS. 249

9. The injury which is done to the feet by frost.

10. The injury which is sometimes done to one
of the toes, by stumping it (as it is called) in
walking.

11. Cutting a nail too closely. Also,

12. Cutting a corn too closely.

13. Wearing a shoe so tight as to abrade the
skin of one of the toes.

14. A wound, not more than an eighth part of an
inch, upon the forehead.

15. The stroke of a whip upon the arm, which
only broke the skin.

16. Walking too soon upon a broken limb.

17. The sting of a wasp upon the glands penis,

18. A fish bone sticking in the throat.

19. Cutting the navel string in new-born in-
fants.

vol. i. 2 I

£50 OBSERVATIONS ON THE TETANUS.

Between the time in which the body is thus
wounded or injured, and the time in which the
disease makes its appearance, there is an interval
which extends from one day to six weeks. In the
person who injured his toe by stumping it in
walking, the disease appeared the next day. The
trifling wound on the forehead which I have men-
tioned, produced both tetanus and death, the day
after it wras received. I have known two instances
of tetanus, from running nails in the feet, which
did not appear until six weeks afterwards. In most
of the cases of this disease from wounds which I
have seen, there was a total absence of pain and
inflammation, or but very moderate degrees of
them, and in some of them the wounds had entirely
healed, before any of the symptoms of the disease
had made their appearance. Wounds and lsesions
are most apt to produce tetanus, after the long con-
tinued application of heat to the body ; hence its
greater frequency, from these causes, in warm than
in cold climates, and in warm than in cold wea-
ther, in northern countries.

II. Cold applied suddenly to the body, after it
has been exposed to intense heat. Of this Dr.
Girdlestone mentions many instances, in his Trea-
tise upon Spasmodic Affections in India. It was
most commonly induced by sleeping upon the

OBSERVATIONS ON THE TETANUS. 251

ground, after a warm day. Such is the dampness
and unwholesome nature of the ground, in some
parts of that country, that " fowls (the doctor
says) put into coops at night, in the sickly season
of the year, and on the same soil that the men slept,
were always found dead the next morning, if
the coop was not placed at a certain height above
the surface of the earth*." It was brought on by
sleeping on a damp pavement in a servant girl of
Mr. Alexander Todd of Philadelphia, in the eve-
ning of a day in which the mercury in Fahrenheit's
thermometer stood at 90°. Dr. Chalmers relates
an instance of its having been induced by a person's
sleeping without a nightcap, after shaving his head.
The late Dr. Bartram informed me, that he had
known a draught of cold water produce it in a
man who was in a preternaturally heated state.
The cold air more certainly brings on this disease,
if it be applied to the body in the form of a current.
The stiff neck which is sometimes felt after expo-
sure to a stream of cool air from an open window,
is a tendency to a locked jaw, or a feeble and par-
tial tetanus.

III. Worms and certain acrid matters in the
alimentary canal. Morgagni relates an instance of

* Page 55,

252 OBSERVATIONS ON THE TETANUS.

the former, and I shall hereafter mention instances
of the latter in new-born infants.

IV. Certain poisonous vegetables. There are
several cases upon record of its being induced by
the hemlock drop wort, and the datura stramonium,
or Jamestown weed of our country.

V. It is sometimes a symptom of the bilious
remitting and intermitting fever. It is said to oc-
cur more frequently in those states of fever in the
island of Malta, than in any other part of the world.

VI. It is likewise a symptom of that malignant
state of fever which is brought on by the bite of a
rabid animal, also of hysteria and gout.

VII. The grating noise produced by cutting
with a knife upon a pewter plate excited it in a
servant, while he was "waiting upon his master's
table in London. It proved fatal in three days.

VIII. The sight of food, after long fasting.

IX. Drunkenness.

X. Certain emotions and passions of the mind.
Terror brought it on a brewer in this city. He

OBSERVATIONS ON THE TETANUS. 253

had been previously debilitated by great labour, in
warm weather. I have heard of its having been
induced in a man by agitation of mind, occasioned
by seeing a girl tread upon a nail. Fear excited
it in a soldier who kneeled down to be shot. Upon
being pardoned he was unable to rise, from a sud-
den attack of tetanus. Grief produced it in a
case mentioned by Di\ Willan.

XL Parturition.

All these remote and exciting causes act with
more or less certainty and force, in proportion to
the greater or less degrees of fatigue which have
preceded them.

It has been customary with authors to call all
those cases of tetanus, which are not brought on
by wounds, symptomatic. They are no more so
than those which are said to be idiopathic. They
all depend alike upon irritating impressions, made
upon one part of the body, producing morbid ex-
citement, or disease in another. It is immaterial,
whether the impression be made upon the intes-
tines by a worm, upon the ear by an ungrateful
noise, upon the mind by a strong emotion, or upon
the sole of the foot by a nail ; it is alike commu-

254 OBSERVATIONS ON THE TETANUS.

nicated to the muscles, which, from their previous
debility and irritability, are thrown into commo-
tions by it. In yielding to the impression of irri-
tants, they follow in their contractions the order of
their predisposing debility. The muscles which
move the lower jaw are affected more early, and
more obstinately than any of the other external
muscles of the body, only because they are more
constantly in a relaxed, or idle state.

The negroes in the West- Indies are more sub-
ject to this disease than white people. This has
been ascribed to the greater irritability of their
muscular systems, which constitutes a part of its
predisposing cause. It is remarkable that their sen-
sibility lessens with the increase of their irritability ;
and hence, Dr. Moseley says, they bear surgical
operations much better than white people.

New-born infants are often affected by this dis-
ease in the West- Indies. I have seen a few cases
of it in Philadelphia. It is known by the name of
the jaw-fall. Its causes are :

1. The cutting of the navel string. This is
often done with a pair of dull scissars, by which
means the cord is bruised.

OBSERVATIONS ON THE TETANUS. 255

r ' 2. The acrimony of the meconium retained in
the bowels.

3. Cold air acting upon the body, after it hast
been heated by the air of a hot room.

4. Smoke is supposed to excite it, in the negro
quarters in the West- Indies.

It is unknown, Dr. Winterbottom informs us,
among the native Africans in the neighbourhood of
Sierra Leone.

I am aware that it is ascribed by many physi-
cians to only one of the above causes ; but I see
no reason why it should not be induced by more
than one cause in infants, when we see it brought
on by so many different causes in grown people.

The tetanus is not confined to the human species.
It often affects horses in the West-Indies. I have
seen several cases of it in Philadelphia.

The want of uniform success in the treatment of
this disease, has long been a subject of regret
among physicians. It may be ascribed to the use
of the same remedies, without any respect to the
nature of the causes which produce it, and to an

256 OBSERVATIONS ON THE TETANUS.

undue reliance upon some one remedy, under a
belief of its specific efficacy. Opium has been
considered as its antidote, without recollecting that
it was one only, of a numerous class of medicines,
that are all alike useful in it.

Tetanus, from all its causes, has nearly the same
premonitory symptoms. These are a stiffness in the
neck, a disposition to bend forward, in order to
relieve a pain in the back, costiveness, a pain about
the external region of the stomach, and a disposi-
tion to start in sleep. In this feeble state of the
disease, an emetic, a strong dose of laudanum, the
w arm bath, or a few doses of bark, have often pre-
vented its being completely formed. When it has
arisen from a wound, dilating it if small or healed,
and afterwards inflaming it, by applying to it tur-
pentine, common salt, corrosive sublimate, or Spa-
nish flies, have, in many hundred instances, been
attended with the same salutary effects.

The disease I have said is seated in the muscles,
and, while they are preternaturally excited, the
blood-vessels are in a state of reduced excitement.
This is evident from the feebleness and slowness
of the pulse. It sometimes beats, according to
Dr. Lining, but forty strokes in a minute. By
stimulating the wound, we not only restore the

OBSERVATIONS ON THE TETANUS. 257

natural excitement of the blood-vessels, but we
produce an inflammatory diathesis in them, which
abstracts morbid excitement from the muscular
system, and, by equalizing it, cures the disease.
This remedy I acknowledge has not been as suc-
cessfully employed in the West- Indies as in the
United States, and that for an obvious reason.
The blood-vessels in a warm climate refuse to as-
sume an inflammatory action. Stimuli hurry
them on suddenly to torpor or gangrene. Hence
the danger and even fatal effects of blood-letting,
in the fevers which affect the natives of the islands,
a few hours after they are formed. But widely
different is the nature of wounds, and of the ten-
sion of the blood-vessels, in the inhabitants of nor-
thern countries. While Dr. Dallas deplores the
loss of 49 out of 50 affected with tetanus from
wounds, in the West- India islands, I am sure I
could mention many hundred instances of the dis-
ease being prevented, and a very different propor-
tion of cures being performed, by inflaming the
wounds, and exciting a counter morbid action in
the blood-vessels.

When the disease is the effect of fever, the
same remedies should be given, as are employed
in the cure of that fever. I have once unlocked
the jaw of a woman who was seized at the same

vol. i. 2 K

258 OBSERVATIONS ON THE TETANUS.

time with a remitting fever, by an emetic, and I
have heard of its being cured in a company of sur-
veyors, in whom it was the effect of an intermit-
tent, by large doses of bark. When it accom-
panies malignant fever, hysteria, or gout, the reme-
dies for those forms of disease should be employed.
Bleeding was highly useful in it in a case of yellow
fever which occurred in Philadelphia in the year
1794.

When it is produced by the suppression of per-
spiration by means of cold, the warm bath and
sweating medicines have been found most useful
in it. Nature has in one instance pointed out the
use of this remedy, by curing the disease by a mi-
liary eruption on the skin*.

If it be the effect of poisonous substances taken
into the stomach, or of worms in the bowels, the
cure should be begun by emetics, purges, and an-
thelmintic medicines.

Where patients are unable to swallow, from the
teeth of the upper and lower jaw pressing upon
each other, a tooth or two should be extracted,
to open a passage for our medicines into the throat.

* fiurserus.

OBSERVATIONS ON THE TETANUS. 259

If this be impracticable or objected to, they should
be injected by way of glyster.

In the locked jaw which arises from the extrac-
tion of a tooth, an instrument should be introduced
to depress the jaw. This has been done by a
noted English dentist in London, with success.

As the habit of diseased action often continues
after the removal of its causes, and as some of the
remote causes of this disease are beyond the reach
of medicine, such remedies should be given as are
calculated, by their stimulating power, to overcome
the morbid or spasmodic action of the muscles.
These are :

1. Opium. It should be given in large and
frequent doses. Dr. Streltz says he has found
from one to two drachms of an alkali, taken in the
course of a day, greatly to aid the action of the
opium in this disease.

2. Wine. This should be given in quarts, and
even gallons daily. Dr. Currie relates a case of a
man in the infirmary of Liverpool, who was cured
of tetanus, by drinking nearly a quarter cask of
Madeira wine. Dr. Hosack speaks in high terms
of it, in a letter to Dr. Duncan, and advises its

260 OBSERVATIONS ON THE TETANUS.

being given without any other stimulating medi-
cine.

3. Ardent spirits. A quack in New-Eng-
land has lately cured tetanus, by giving ardent spi-
rits in such quantities as to produce intoxication.
Upon being asked his reason for this strange prac-
tice, he said, he had always observed the jaw to fall
in drunken men, and any thing that would produce
that effect, he supposed to be proper in the locked
jaw.

4. The bark has of late vears been used in this
disease with success. I had the pleasure of first
seeing its good effects in the case of Colonel Stone,
in whom a severe tetanus followed a wound in the
foot, received at the battle of Germantown, in Oc-
tober, 1777.

5. The cold bath. This remedy has been
revived by Dr. Wright of Jamaica, and has in many
instances performed cures of this disease. In one
of two cases in which I have used it with success,
the patient's jaw opened in a few minutes after the
affusion of a single bucket of water upon her body.
The disease was occasioned by a slight injury done
to one of her toes, by wearing a tight shoe. The
•signals for continuing the use of the cold bath, are

OBSERVATIONS ON THE TETANUS. 261

its being followed by a slight degree of fever, and
a general warmth of the skin. Where these do
not occur, there is reason to believe it will do no
service, or perhaps do harm. We have many
proofs of the difference in the same disease, and in
die operation of the same medicine, in different and
opposite climates. Dr. Girdlestone has mentioned
the result of the use of the cold bath in tetanus in
the East- Indies, which furnishes a striking addition
to the numerous facts that have been collected upon
that subject. He tells us the cold bath uniformly
destroyed life, in every case in which it was used.
The reason is obvious. In that extremely debili-
tating climate, die system in tetanus was prostrated
too low to re-act, under the sedative operation of
the cold water.

6. The warm bath has often been used with
success in this disease. Its temperature should be
regulated by our wishes to promote sweats, or to
produce excitement in the blood-vessels. In the
latter case it should rise above the heat of the hu-
man body.

7. The oil of amber acts powerfully upon
the muscular system. I have seen the happiest
effects from the exhibition of six or eight drops of
it, every two hours, in this disease.

262 OBSERVATIONS ON THE TETANUS.

8. A salivation has been often recommended
for the cure of tetanus, but unfortunately it can
seldom be excited in time to do service. I once
saw it complete the cure of a sailor in the Pennsyl-
vania hospital, whose life was prolonged by the
alternate use of bark arid wine. The disease was
brought on him by a mortification of his feet, in
consequence of their being frost-bitten.

9. Dr. Girdlestone commends blisters in
high terms in this disease. He says he never saw
it prove fatal, even where they only produced a
redness on the skin.

10. I have heard of electricity having been
used with advantage in tetanus, but I can say no-
thing in its favour from my own experience.

In order to ensure the utmost benefit from the
use of the above remedies, it will be necessary for
a physician always to recollect, that the disease is
attended with great morbid action, and of course
each of the stimulating medicines that has been
mentioned should be given, 1st, in large doses ;
2dly, in succession ; 3dly, in rotation ; and 4thly,
by way of glyster, as well as by the mouth.

OBSERVATIONS ON THE TETANUS. 263

The jaw-fall in new-born infants is, I believe,
always fatal. Purging off the meconium from the
bowels immediately after birth has often prevented
it from one of its causes ; and applying a rag wet-
ted with spirit of turpentine to the navel-string, im-
mediately after it is cut, Dr. Chisholm says, pre-
vents it from another of its causes which has been
mentioned.

This disease, I have said, sometimes affects
horses. I have twice seen it cured by applying a
potential caustic to the neck under the mane, by
large doses of the oil of amber, and by plunging
one of them into a river, and throwing buckets of
cold water upon the other.

I shall conclude my observations upon the teta-
nus with the following queries :

1. What would be the effects of copious blood-
Jetting in this disease ? There is a case upon re-
cord of its efficacy, in the Medical Journal of Paris,
and I have now in my possession a letter from the
late Dr. Hopkins of Connecticut, containing the
history of a cure performed by it. Where tetanus
is the effect of primary gout, hysteria, or fever, at-
tended with highly inflammatory symptoms, bleed-
ing is certainly indicated, but, in general, the dis-

264 OBSERVATIONS ON THE TETANUS.

i

ease is so completely insulated in the muscles, and
the arteries are so far below their par of excite,
ment in frequency and force, that little benefit can
be expected from that remedy. The disease, in
these cases, seems to call for an elevation, instead
of a diminution, of the excitement of the blood-
vessels.

2. What would be the effect of extreme cold in
this disease ? Mr. John Hunter used to say, in
his lectures, " Were he to be attacked by it, he
would, if possible, fly to Nova-Zembla, or throw
himself into an ice-house." I have no doubt of
the efficacy of intense cold, in subduing the inordi-
nate morbid actions which occur in the muscular
system ; but it offers so much violence to the
fears and prejudices of sick people, or their friends,
that it can seldom be applied in such a manner as
to derive much benefit from it. Perhaps the seda-
tive effects of cold miffht be obtained with less
difficulty, by wrapping the body in sheets, and
wetting them occasionally for an hour or two with
cold water.

3. What would be the effect of exciting a strong
counter- action in the stomach and bowels in this
disease ? Dr. Brown of Kentucky cured a tetanus
by inflaming the stonuch, by means of the tincture

OBSERVATIONS ON THE TETANUS. 265

of cantharides. It has likewise been cured by a
severe cholera morbus, induced by a large dose of
corrosive sublimate. The stomach and bowels, and
the external muscles of the body, discover strong
associations in many diseases. A sick stomach is
always followed by general weakness, and the dry
gripes often paralyze the muscles of the arms and
limbs. But further, one of the remote causes of
tetanus, viz. cold air, often shows the near relation-
ship of the muscles to the bowels, and the vicarious
nature of disease in each of them. It often pro-
duces in the latter, in the West- Indies, what the
French physicians call a " crampe seche," or, in
other words, if I may be allowed the expression, a
tetanus in the bowels.

4. A sameness has been pointed out between
many of the symptoms of hydrophobia and te-
tanus. A similar difficulty of swallowing, and
similar convulsions after it, have been remarked in
both diseases. Death often takes place suddenly
in tetanus, as it does in hydrophobia, without pro-
during marks of fatal disorganization in any of the
internal parts of the body. Dr. Physick supposes
death in these cases to be the effect of suffocation,
from a sudden spasm and closure of the glottis,
and proposes to prevent it in the same manner that
he has proposed to prevent death from hydropho-

vol. i. 2 L

26.6 OBSERVATIONS ON THE TETANUS.

bia, that is, by laryngotomy*. The prospect of
success from it appears alike reasonable in both
cases.

* Medical Repository*

THE RESULT OF OBSERVATIONS

MADE UPON

THE DISEASES

WHICH OCCURRED IN

THE MILITARY HOSPITALS

OF THE UNITED STATES,

DURING THE REVOLUTIONARY WAR BETWEEN GREAT BRITAIN.

AND THE TINITEB STATES.

RESULT OF OBSERVATIONS, &c.

1. THE army when in tents, was always
more sickly, than in the open air. It was likewise
more healthy when it was kept in motion, than
when it lay in an encampment.

2. Young men under twenty years of age, were
subject to the greatest number of camp diseases.

3. The southern troops were more sickly than
the northern or eastern troops.

4. The native Americans were more sickly than
the natives of Europe who served in the Ameri-
can army.

5. Men above thirty, and five and thirty years
of age, were the hardiest soldiers in the army.
Perhaps the reason why the natives of Europe

270 OBSERVATIONS UPON THE

were more healthy than the native Americans, was,
they were more advanced in life.

6. The southern troops sickened from the want
of salt provisions. Their strength and spirits were
restored only by means of salted meat. I once
saw a private in a Virginia regiment, throw away
his ration of choice fresh beef, and give a dollar
for a pound of salted bacon.

7. Those officers who wore flannel shirts or
waistcoats next to their skins, in general escaped
fevers and diseases of all kinds.

8. The principal diseases in the hospitals were
the typhus gravior and mitior of Ccc'or Cullen.
Men who came into the hospitals with pleurisies
or rheumatisms, soon lost the types of their ori-
ginal diseases, and suffered, or died, by the above-
mentioned states of fever.

9. The typhus mitior always prevailed most, and
with the worst symptoms in winter. A free air,
which could only be obtained in summer, always
prevented, or mitigated it.

10. In all those cases, where the contagion
was received, cold seldom failed to render it ac-

DISEASES OF MILITARY HOSPITALS. 271

tive. Whenever an hospital was removed in win-
ter, one half of the patients generally sickened on
the way, or soon after their arrival at the place to
which they were sent.

11. Drunken soldiers and convalescents wTere
most subject to this fever.

12. Those patients in this fever who had large
ulcers on their back or limbs, generally recover-
ed.

13. I met with several instances of buboes, also
of ulcers in the throat, as described by Doctor
Donald Monro. They were mistaken by some of
the junior surgeons for venereal sores, but they
yielded to the common remedies of the hospital
fever.

14. There were many instances of patients in
this fever, who suddenly fell down dead, upon
being moved, without any previous symptoms of
approaching dissolution. This was more especially
the case, when they arose to go to stool.

16. The contagion of this fever was frequently
conveyed from the hospital to the camp, by means
of blankets and clothes.

272 OBSERVATIONS UPON THE

16. Those black soldiers who had been pre-
viously slaves, died in a greater proportion by this
fever, or had a much slower recovery from it, than
the same number of white soldiers.

17. The remedies which appeared to do most
service in this disease were vomits of tartar eme-
tic, gentle dozes of laxative salts, bark, wine, vola-
tile salt, opium, and blisters.

18. An emetic seldom failed of checking this
fever if exhibited while it was in a forming state,
and before the patient was confined to his bed.

19. Many causes concurred to produce, and
increase this fever ; such as the want of cleanliness,
excessive fatigue, the ignorance or negligence of
officers in providing suitable diet and accommo-
dations for their men, the general use of linen
instead of woollen clothes in the summer months,
and the crowding too many patients together in
one hospital, with such other inconveniences and
abuses, as usually follow the union of the pur-
veying and directing departments of hospitals in the
same persons. But there is one more cause of this
fever which remains to be mentioned, and that is,
the sudden assembling of a great number of per-
sons together of different habits and manners, such

it

DISEASES OF MILITARY HOSPITALS. 273

as the soldiers of the American army were in the
years 1776 and 1777. Doctor Blane informs us,
in his observations upon the diseases of seamen,
" that it sometimes happens that a ship with a
" long established crew shall be very healthy^ yet
if strangers are introduced among them, who
tl are also healthy , sickness will be mutually pro-
*' duced." The history of diseases furnishes many
proofs of the truth of this assertion*. It is very
remarkable, that while the American army at
Cambridge, in the year 1775, consisted only of
New-Englandmen (whose habits and manners were
the same) there was scarcely any sickness among
them. It was not till the troops of the eastern,
middle, and southern states met at New- York and
Ticonderoga, in the year 1776, that the typhus
became universal, and spread with such peculiar
mortality in the armies of the United States.

20. The dysentery prevailed, in the summer of
1777, in the military hospitals of New- Jersey, but

* " Cleanliness is founded on a natural aversion to what
is unseemly and offensive in the persons of others ; and there
seems also to be an instinctive horror at strangers implanted
in human nature for the same purpose, as is visible in young
children, and uncultivated people. In the early ages of
Rome, the same word signified both a stranger and an ene-
my." Dr. Blane, p. 225.

VOL. I. 2m

274 OBSERVATIONS UPON THE

with very few instances of mortality. This dysen-
tery was frequently followed by an obstinate diarr-
hoea, in which the warm bath was found in many
cases to be an effectual remedy.

21. I saw several instances of fevers occasioned
by the use of the common ointment made of the
flour of sulphur and hog's lard, for the cure of the
itch. The fevers were probably brought on by
the exposure of the body to the cold air, in the
usual method in which that ointment is applied. I
have since learned, that the itch may be cured as
speedily by rubbing the parts affected, two or three
times, with the dry flour of sulphur, and that no
inconvenience, and scarcely any smell, follow this
mode of using it.

22. In gun-shot wounds of the joints, Mr,
Ranby's advice of amputating the limb was fol-
lowed with success. I saw two cases of death where
this advice was neglected.

23. There was one instance of a soldier who
lost his hearing, and another of a soldier who had
been deaf who recovered his hearing, by the noise
of artillery in a battle.

DISEASES OF MILITARY HOSPITALS. 275

24. Those soldiers who were bilietted in private
houses, generally escaped the hospital fever, and
recovered soonest from all their diseases.

25. Hospitals built of coarse logs, with ground
floors, with fire-places in the middle of them, and
a hole in the roof, for the discharge of smoke,
were found to be very conducive to the recovery
of the soldiers from the hospital fever. This form
of a military hospital was introduced into the army
by Dr. Tilton of the state of Delaware*.

26. In fevers and dysenteries, those soldiers re-
covered most certainly, and most speedily, who lay
at the greatest distance from the walls of the hos-
pitals. This important fact was communicated to
me by the late Dr. Beardsley of Connecticut.

27. Soldiers are but little more than adult chil-
dren. That officer, therefore, will best perform
his duty to his men, who obliges them to take the
most care of their health.

* " It is proved, in innumerable instances, that sick men
recover health sooner and better in sheds, huts, and barns,
exposed occasionally to wind, and sometimes to rain, than
in the most superb hospitals in Europe." Jackson's Re-
marks on the Constitution of the Medical Department of
the British Army, p. 340.

j27G OBSERVATIONS UPON" THE, &C

28. Hospitals are the sinks of human life in an
army. They robbed the United States of more
citizens than the sword. Humanity, economy,
and philosophy, all concur in giving a preference
to the conveniences and wholesome air of private
houses ; and should war continue to be the absurd
and unchristian mode of deciding national disputes>
it is to be hoped that the progress of science will
so far mitigate one of its greatest calamities, as to
produce an abolition of hospitals for acute diseases.
Perhaps there are no cases of sickness in which
reason and religion do not forbid the seclusion of
our fellow creatures from the offices of humanity in
private families, except where they labour under
the calamities of madness and the venereal disease,
or where they are the subjects of some of the ope*,
rations of surgery.

AN ACCOUNT OF THE INFLUENCE

OF THE

MILITARY AND POLITICAL EVENTS

OF THE

AMERICAN REVOLUTION

UPON THE

HUMAN BODY.

AN ACCOUNT, &c.

THERE were several circumstances pecu-
liar to the American revolution, which should be
mentioned previously to an account of the influence
of the events which accompanied it, upon the hu-
man body.

1. The revolution interested every inhabitant
of the country of both sexes, and of every rank and
age that was capable of reflection. An indifferent,
or neutral spectator of the controversy, was scarcely
to be found in any of the states.

2. The scenes of war and government which it
introduced, were new to the greatest part of the
inhabitants of the United States, and operated with
all the force of novelty upon the human mind.

280 INFLUENCE OF THE REVOLUTION

3. The controversy was conceived to be the
most important of any that had ever engaged the
attention of mankind. It was generally believed,
by the friends of the revolution, that the very ex-
istence of freedom upon our globe, was involved
in the issue of the contest in favour of the United
States.

4. The American revolution included in it the
cares of government, as well as the toils and dan-
gers of war. The American mind was, therefore,
frequently occupied at the same time, by the diffi-
cult and complicated duties of political and military
life.

5. The revolution was conducted by men who
had been born/m*, and whose sense of the blessings
of liberty was of course more exquisite than if they
had just emerged from a state of slavery.

6. The greatest part of the soldiers in the armies
of the United States had family connections and
property in the country.

7. The war was carried on by the Americans
against a nation, to whom they had long been tied
by the numerous obligations of consanguinity, laws,
religion, commerce, language, interest, and a mu*

UPON THE HUMAN BODY. 281

tual sense of national glory. The resentments of
the Americans of course rose, as is usual in all
disputes, in proportion to the number and force of
these ancient bonds of affection and union.

8. A predilection to a limited monarchy, as an
essential part of a free and safe government, and an
attachment to the reigning king of Great-Britain
(with a very few exceptions), were universal in
every part of the United States.

9. There was at one time a sudden dissolution
of civil government in all, and of ecclesiastical
establishments in several of the states.

10. The expences of the war were supported
by means of a paper currency, which was continu-
ally depreciating.

From the action of each of these causes, and
frequently from their combination in the same per-
sons, effects might reasonably be expected, both
upon the mind and body, which have seldom oc-
curred ; or if they have, I believe were never fully
recorded in any age or country.

It might afford some useful instruction, to point
out the influence of the military and political events
vol. i, 2 N

282 INFLUENCE OF THE REVOLUTION

of the revolution upon the understandings, passions,
and morals of the citizens of the United States ;
but my business in the present inquiry, is only to
take notice of the influence of those events upon
the human body, through the medium of the mind.

I shall first mention the effects of the military,
and secondly, of the political events of the revolu-
tion. The last must be considered in a two-fold
view, accordingly as they affected the friends, or
the enemies of the revolution.

I. In treating of the effects of the military events,
I shall take notice, first, of the influence of actual
war, and, secondly, of the influence of the military
life.

In the beginning of a battle, I have observed
thirst to be a very common sensation among both
officers and soldiers. It occurred where no exer-
cise, or action of the body, could have excited it.

Many officers have informed me, that after the
first onset in a battle, they felt a glow of heat, so
universal as to be perceptible in both their ears.
This was the case, in a particular manner, in the
battle of Princeton, on the third of January, in the

UPON THE HUMAN BODY. 283

year 1777, on which day the weather was remark-
ably cold.

A veteran colonel of a New- England regiment,
whom I visited at Princeton, and who was wound-
ed in the hand at the battle of Monmouth, on the
28th of June, 1778 (a day in which the mercury
stood at 90° of Fahrenheit's thermometer), after de-
scribing his situation at the time he received his
wound, concluded his story by remarking, that
" fighting was hot work on a cold day, but much
" more so on a warm day." The many instances
which appeared after that memorable battle, of
soldiers who were found among the slain without
any marks of wounds or violence upon their bo-
dies, were probably occasioned by the heat excited
in the body, by the emotions of the mind, being
added to that of the atmosphere.

Soldiers bore operations of every kind immedi-
ately after a battle, with much more fortitude than
they did at any -time afterwards.

The effects of the military life upon the human
body come next to be considered under this head.

In another place* I have mentioned three cases

* Page 204.

284 INFLUENCE OF THE REVOLUTION

of pulmonary consumption being perfectly cured
by the diet and hardships of a camp life.

Doctor Blane, in his valuable observations on
the diseases incident to seamen, ascribes the ex-
traordinary healthiness of the British fleet in the
month of April, 1782, to the effects produced on
the spirit of the soldiers and seamen, by the vic-
tory obtained over the French fleet on the 12th
of that month ; and relates, upon the authority of
Mr. Ives, an instance in the war between Great-
Britain and the combined powers of France and
Spain, in 1744, in which the scurvy, as well as
other diseases, were checked by the prospect of a
naval engagement.

The American army furnished an instance of
the effects of victory upon the human mind, which
may serve to establish the inferences from the facts
related by Doctor Blane. The Philadelphia mi-
litia who joined the remains of General Washing-
ton's army, in December, 1776, and shared with
them a few days afterwards in the capture of a
large body of Hessians at Trenton, consisted of
1500 men, most of whom had been accustomed
to the habits of a city life. These men slept in
tents and barns, and sometimes in the open air
during the usual colds of December and January ;

UPON THE HUMAN BODY. 285

and yet there were but two instances of sickness,
and only one of death, in that body of men in the
course of nearly six weeks, in those winter months.
This extraordinary healthiness of so great a num-
ber of men under such trying circumstances, can
only be ascribed to the vigour infused into the
human body by the victory of Trenton having
produced insensibility to all the usual remote causes
of diseases.

Militia officers and soldiers, who enjoyed good
health during a campaign, were often affected by
fevers and other diseases, as soon as they return-
ed to their respective homes. I knew one instance
of a militia captain, who was seized with convul-
sions the first night he lay on a feather bed, after
sleeping several months on a mattrass, or upon the
ground. These affections of the body appeared
to be produced only by the sudden abstraction of
that tone in the system which was excited by a
sense of danger, and the other invigorating objects
of a military life.

The nostalgia of Doctor Cullen, or the
home -sickness, was a frequent disease in the Ame-
rican army, more especially among the soldiers of
the New- England states. But this disease was
suspended by the superior action of the mind un-

286 INFLUENCE OF THE REVOLUTION

der the influence of the principles which governed
common soldiers in the American army. Of this
General Gates furnished me with a remarkable in-
stance in 1776, soon after his return from the
command of a large body of regular troops and
militia at Ticonderoga. From the effects of the
nostalgia, and the feebleness of the discipline,
which was exercised over the militia, desertions
were very frequent and numerous in his army, in
the latter part of the campaign ; and yet during
the three weeks in which the general expected every
hour an attack to be made upon him by General
Burgoyne, there was not a single desertion from
his army, which consisted at that time of 10,000
men.

The patience, firmness, and magnanimity with
which the officers and soldiers of the American
army endured the complicated evils of hunger,
cold, and nakedness, can only be ascribed to an
insensibility of body produced by an uncommon
tone of mind excited by the love of liberty and
their country.

Before I proceed to the second general division
of this subject, I shall take notice, that more in-
stances of apoplexies occurred in the city of Phi-
ladelphia> in the winter of 1774-5, than had been

UPON THE HUMAN BODY. 287

known in former years. I should have hesitated
in recording this fact, had I not found the obser-
vation supported by a fact of the same kind, and
produced by a nearly similar cause, in the appendix
to the practical works of Doctor Baglivi, professor
of physic and anatomy at Rome. After a very
wet season in the winter of 1694-5, he informs
us, that " apoplexies displayed their rage ; and
" perhaps (adds our author) that some part of this
" epidemic illness was owing to the universal grief
" and domestic care, occasioned by all Europe be-
" ing engaged in a war. All commerce was dis-
" turbed, and all the avenues of peace blocked up,
" so that the strongest heart could scarcely bear
" the thoughts of it." The winter of 1774-5 was
a period of uncommon anxiety among the citizens
of America. Every countenance wore the marks
of painful solicitude, for the event of a petition to
the throne of Britain, which was to determine whe-
ther reconciliation, or a civil war, with all its terri-
ble and distressing consequences, were to take
place. The apoplectic fit, which deprived the
world of the talents and virtues of Peyton Ran-
dolph, while he filled the chair of congress, in 1775,
appeared to be occasioned in part by the pressure
of the uncertainty of those great events upon his
mind. To the name of this illustrious patriot,
several others might be added, who were affected

288 INFLUENCE OE THE REVOLUTION

by the apoplexy in the same memorable year. At
this time a difference of opinion upon the subject
of the contest with Great-Britain, had scarcely
taken place among the citizens of America.

II. The political events of the revolution pro-
duced different effects upon the human body,
through the medium of the mind, according as
they acted upon the friends or enemies of the re-
volution.

I shall first describe its effects upon the former
class of citizens of the United States.

Many persons, of infirm and delicate habits,
were restored to perfect health, by the change of
place, or occupation, to which the war exposed
them. This was the case in a more especial man-
ner with hysterical women, who were much inte-
rested in the successful issue of the contest. The
same effects of a civil war upon the hysteria, were
observed by Doctor Cullen in Scotland, in the
years 1745 and 1746. It may perhaps help to
extend our ideas of the influence of the passions
upon diseases, to add, that when either love, jea-
lousy, grief, or even devotion, wholly engross the
female mind, they seldom fail, In like manner, to
cure or to suspend hysterical complaints.

UPON THE HUMAN BODY. 289

All uncommon cheerfulness prevailed every
where, among the friends of the revolution. De-
feats, and even the loss of relations and property,
were soon forgotten in the great objects of the
war.

The population in the United States was more
rapid from births during the war, than it had ever
been in the same number of years since die settle-
ment of the country.

I am disposed to ascribe this increase of births
chiefly to the quantity and extensive circulation of
money, and to the facility of procuring the means
of subsistence during the war, which favoured
marriages among the labouring part of the peor
pie*. But I have sufficient documents to prove,
that marriages were more fruitful than in former
years, and that a considerable number of unfruit-
ful marriages became fruitful during the war. In
1783, the year of the peace, there were several

* Wheat, which was sold before the war for seven shil-
lings and sixpence, was sold for several years during the war
for four, and in some places for two and sixpence Pennsyl-
vania currency per bushel. Beggars of every description
disappeared in the year 1776, and were seldom seen till
near the close of the war.

VOL. I. 2 O

&9Q INFLUENCE OF THE REVOLUTION

children born of parents who had lived many years,
together without issue.

Mr. Hume informs us, in his History of Eng-
land, that some old people, upon hearing the news
of the restoration of Charles II, died suddenly
of joy. There was a time when I doubted the
truth of this assertion ; but I am now disposed to
believe it, from having heard of a similar effect
from an agreeable political event, in the course of
the American revolution. The door-keeper of
congress, an aged man, died suddenly, immedi-
ately after hearing of the capture of Lord Corn-
wallis' army. His death was universally ascribed
to a violent emotion of political joy. This species
of joy appears to be one of the strongest emotions
that can agitate the human mind.

Perhaps the influence of that ardour in trade
and speculation, which seized many of the friends
of the revolution, and which was excited by the
fallacious nominal amount of the paper money,
should rather be considered as a disease, than as a
passion. It unhinged the judgment, deposed the
moral faculty, and filled the imagination, in many
people, with airy and impracticable schemes of
wealth and grandeur. Desultory manners, and a
peculiar species of extempore conduct, were among

UTON THE HUMAN BODY. 291

its characteristic symptoms. It produced insensi-
bility to cold, hunger, and danger. The trading
towns, and in some instances the extremities of
the United States, were frequently visited in a few
hours or days by persons affected by this disease ;
and hence " to travel with the speed of a specu-
" lator," became a common saying in many parts
of the country. This species of insanity (if I may
be allowed to call it by that name) did not require
the confinement of a bedlam to cure it, like the
South- Sea madness described by Doctor Mead.
Its remedies were the depreciation of the paper
money, and the events of the peace.

The political events of the revolution produced
upon its enemies very different effects from those
which have been mentioned.

The hypochondriasis of Doctor Cullen occur-
red, in many instances, in persons of this descrip-
tion. In some of them, the terror and distress of
the revolution brought on a true melancholia*.
The causes which produced these diseases may be
reduced to four heads. 1. The loss of former
power or influence in government. 2. The des-
truction of the hierarchy of the English church in

* Insania partialis sine dyspepsia, of Doctor Cullen.

292 INFLUENCE OF THE REVOLUTION

America. 3. The change in the habits of diet,
and company, and manners, produced by the anni-
hilation of just debts by means of depreciated paper
money. And 4. The neglect, insults, and oppres-
sion, to which the loyalists were exposed, from in-
dividuals, and, in several instances, from the laws
of some of the states.

It was observed in South- Carolina, that several
gentlemen who had protected their estates by
swearing allegiance to the British government, died
soon after the evacuation of Charleston by the Bri-
tish army. Their deaths were ascribed to the
neglect with which they were treated by their an-
cient friends, who had adhered to the government
of the United States. The disease was called, by
the common people, the protection fever.

From the causes which produced this hypochon-
driasis, I have taken the liberty of distinguishing it
by the name of revolutiana.

In some cases, this disease was rendered fatal
by exile and confinement ; and, in others, by
those persons who were afflicted with it, seeking
relief from spiritous liquors.

UPON THE HUMAN BODY. 293

The termination of the war by the peace in
1783, did not terminate the American revolution.
The minds of the citizens of the United States
were wholly unprepared for their new situation.
The excess of the passion for liberty, inflamed by
the successful issue of the war, produced, in many
people, opinions and conduct which could not be
removed by reason nor restrained by government.
For a while, they threatened to render abortive
the goodness of heaven to the United States, in
delivering them from the evils of slavery and war.
The extensive influence which these opinions had
upon the understandings, passions, and morals of
many of the citizens of the United States, consti-
tuted a form of insanity, which I shall take the
liberty of distinguishing by the name of anarchia*

I hope no offence will be given by the freedom
of any of these remarks. An inquirer after philo-
sophical truth should consider the passions of men
in the same light that he does the laws of matter
or motion. The friends and enemies of the Ame-
rican revolution must have been more, or less than
men, if they could have sustained the magnitude
and rapidity of the events that characterised it,
without discovering some marks of human weak-
ness, both in body and mind. Perhaps these weak-
nesses were permitted, that human nature might

294 INFLUENCE OF THE REVOLUTION, &C.

receive fresh honours in America, by the contend-
ing parties (whether produced by the controver-
sies about independence or the national govern-
ment) mutually forgiving each other, and uniting
in plans of general order, and happiness.

*•

AN INQUIRY

>
INTO

THE RELATION OF

TASTES AND ALIMENTS

TO EACH OTHER,

AND

INTO THE INFLUENCE OF THIS RELATION

UPON

HEALTH AND PLEASURE.

• «

AN INQUIRY, &c.

IN entering upon this subject, I feel like
the clown, who, after several unsuccessful attempts
to play upon a violin, threw it hastily from him,
exclaiming at the same time, that " there was mu-
sic in it," but that he could not bring it out.

I shall endeavour, by a few brief remarks, to lay
a foundation for more successful inquiries upon
this difficult subject.

Attraction and repulsion seem to be the active
principles of the universe. They pervade not only
the greatest, but the minutest works of nature.
Salts, earths, inflammable bodies, metals, and ve-
getables, have all their respective relations to each
other. The order of these relations is so uniform,
that it has been ascribed by some philosophers to

vol. r. 2 p

298 THE RELATION OF TASTES AND

a latent principle of intelligence pervading each of
them. .

Colours, odours, and sounds, have likewise their
respective relations to each other. They become
agreeable and disagreeable, only in proportion to
the natural or unnatural combination which takes
place between each of their different species.

It is remarkable, that the number of original
colours and notes in music is exactly the same. All
the variety in both, proceeds from the difference of
combination. An arbitrary combination of them
is by no means productive of pleasure. The rela-
tion which every colour and sound bear to each
other, was as immutably established at the creation,
as the order of the heavenly bodies, or as the rela-
tion of the objects of chemistry to each other.

But this relation is not confined to colours and
sounds alone. It probably extends to the objects
of human aliment. For example, bread and meat,
meat and salt, the alkalescent meats and acescent
vegetables, all harmonize with each other upon the
tongue ; while fish and flesh, butter and raw onions,
fish and milk, when combined, are all offensive to
a pure and healthy taste.

ALIMENTS TO EACH OTHER. 299

It would be agreeable to trace the analogy of
sounds and tastes. They have both their flats and
their sharps. They are both improved by the con-
trast of discords. Thus pepper, and other condi-
ments (which are disagreeable when taken by them-
selves) enhance the relish of many of our aliments,
and they are both delightful in proportion as they
are simple in their composition. To illustrate
this analogy by more examples from music, would
lead us from the subject of the present inquiry.

It is observable that the tongue and the sto-
mach, like instinct and reason, are, by nature, in
unison with each other. One of those organs must
always be disordered, when they disagree in a sin-
gle article of aliment. When they both unite in
articles of diet that were originally disagreeable,
it is owing to a perversion in each of them, similar
to that which takes place in the human mind,
when both the moral faculty and the conscience
lose their natural sensibility to virtue and vice.

Unfortunately for this part of science, the taste
and the stomach are so much perverted in infancy
and childhood by heterogeneous aliment, that it is
difficult to tell what kinds, and mixtures of food are
natural, and what are artificial. It is true, the
system possesses a power of accommodating itself

300 THE RELATION OF TASTES AND

both to artificial food, and to the most discordant
mixtures of that which is natural ; but may we
not reasonably suppose, that the system would pre-
serve its natural strength and order much longer,
if no such violence had been offered to it ?

If the relation of aliments to each other follow s
the analogy of the objects of chemistry, then their
union will be influenced by many external circum-
stances, such as heat and cold, dilution, concen-
tration, rest, motion, and the addition of substances
which promote unnatural, or destroy natural mix-
tures. This idea enlarges the field of inquiry be-
fore us, and leads us still further from facts and
certainty upon this subject, but at the same time
it does not preclude us from the hope of obtaining
both ; for every difficulty that arises out of this
view of the subject, may be removed by observa-
tion and experiment.

I come now to apply these remarks to health
and pleasure. I shall select only a few cases for
this purpose ; for if my principles be true, my
readers cannot avoid discovering many other illus-
trations of them.

1. When an article of diet is grateful to the
taste, and afterwards disagrees with the stomach,

ALIMENTS TO EACH OTHER. 301

may it not be occasioned by some other kind of
food, or by some drink being taken into the sto-
mach, which refuses to unite with the offending
article of diet ?

2. May not the uneasiness which many persons
feel after a moderate meal, arise from its having
consisted of articles of aliment which were not re-
lated to each other ?

3. May not the delicacy of stomach which some-
times occurs after the fortieth or forty-fifth }^ear of
human life, be occasioned by nature recovering
her empire in the stomach, so as to require simpli-
city in diet, or such articles only of aliment as are
related ? May not this be the reason why most
people, who have passed those periods of life, are
unable to retain or to digest fish and flesh at the
same time, and why they generally dine only upon
one kind of food ?

4. Is not the language of nature in favour of
simplicity in diet, discovered by the avidity with
which the luxurious and intemperate often seek
relief from variety and satiety, by retreating to
spring water for drink, and to bread and milk for
aliment ?

302 THE RELATION" OT TASTES AND

5. May not the reason why plentiful meals of
fish, venison, oysters, beef, or mutton, when eaten
alone, lie so easily in the stomach, and digest so
speedily, be occasioned by no other food being
taken with them ? A pound, and even more, of
the above articles, frequently oppress the system
much less than half the quantity of heterogeneous
aliments.

6. Does not the facility with which a due mix-
ture of vegetable and animal food digests in the
stomach, indicate the certainty of their relation to
each other ?

7. May not the peculiar good effects of a diet
wholly vegetable, or animal, be occasioned by the
more frequent and intimate relation of the articles
of the same kingdoms to each other ? And may
not this be the reason why so few inconveniences
are felt from the mixture of a variety of vegetables
in the stomach ?

8. May not the numerous acute and chronic dis-
eases of the rich and luxurious, arise from hetero-
geneous aliments being distributed in a disused,
instead of a mixed state, through every part of the
body f

ALIMENTS TO EACH OTHER. 303

9. May not the many cures which are ascribed
to certain articles of diet, be occasioned more by
their being taken alone, than to any medicinal
quality inherent in them ? A diet of oysters in one
instance, of strawberries in another, and of sugar
of roses in many instances, has cured violent and
dangerous diseases of the breast*. Grapes, ac-
cording to Doctor Moore, when eaten in large
quantities, have produced the same salutary effect.
A milk diet, persisted in for several years, has
cured the gout and epilepsy. I have seen many
cases of dyspepsia cured by a simple diet of beef
and mutton, and have heard of a well-attested case
of a diet of veal alone having removed the same
disease, Squashes, and turnips likewise, when
taken by themselves, have cured that distressing
complaint in the stomach. It has been removed
even by milk, when taken bv itself in a moderate
quantityf. The further the body, and more espe-
cially the stomach, recede from health, the more
this simplicity of diet becomes necessary. The
appetite in these cases does not speak the language
of uncorrupted nature. It frequently calls for va-

* Vansweiten, 1209. 3.

t Medical Observations and Inquiries, vol. VI. p. 310-
319.

304 THE RELATION OF TASTES AND

rious and improper aliment ; but this is the effect
of intemperance having produced an early breach
between the taste and the stomach.

Perhaps the extraordinary cures of obstinate dis-
eases which are sometimes performed by persons
not regularly educated in physic, may be occa-
sioned by a long and steady perseverance in the use
of a single article of the materia medica. Those
chemical medicines which decompose each other,
are not the only substances which defeat the in-
tention of the prescriber. Galenical medicines,
by combination, I believe, frequently produce ef-
fects that are of a compound and contrary nature
to their original and simple qualities. This remark
is capable of extensive application, but I quit it as
a digression from the subject of this inquiry.

10. I wish it to be observed, that I have con-
demned the mixture of different aliments in the
stomach only in a few cases, and under certain cir-
cumstances. It remains yet to determine by ex-
periments, what changes are produced upon ali-
ments by heat, dilution, addition, concentration,
motion, rest, and the addition of uniting substances,
before we can decide upon the relation of aliments
to each other, and the influence of that relation
upon health. The olla podrida of Spain is said

ALIMENTS TO EACH OTHER. 305

to be a pleasant and wholesome dish. It is proba-
bly rendered so, by a previous tendency of all its
ingredients to putrefaction, or by means of heat
producing a new arrangement, or additional new
relations of all its parts. I suspect heat to be a
powerful agent in disposing heterogeneous aliments
to unite with each other ; and hence the mixture
of aliments is probably less unhealthy in France and
Spain, than in England, where so much less fire is
used in preparing them, than in the former coun-
tries.

As too great a mixture of glaring colours, which
are related to each other, becomes painful to the
eye, so too great a mixture of related aliments op-
presses the stomach, and debilitates the powers of
the system. The original colours of the sky, and
of the surface of the globe, have ever been found
the most permanently agreeable to the eye. In
like manner, I am disposed to believe that there
are certain simple aliments which correspond, in
their sensible qualities, with the intermediate co-
lours of blue and green, that are most permanently
agreeable to the tongue and stomach, and that
every deviation from them, is a departure from the
simplicity of health and nature.

vol. i. 2 (^

306 THE RELATION OF TASTES AND

11. While nature seems to have limited us to
simplicity in aliment, is not this restriction abun-
dantly compensated by the variety of tastes which
she allows us to impart to it, in order to diversify
and increase the pleasure of eating ? It is remark-
able that salt, sugar, mustard, horse-radish, capers,
and spices of all kinds, according to Mr. Gosse's
experiments, related by Abbe Spallanzani*, all
contribute not only to render aliments savoury, but
to promote their digestion.

12. When we consider, that part of the art of
cookery consists in rendering the taste of aliments
agreeable, is it not probable that the pleasure of
eating might be increased beyond our present
knowledge upon that subject, by certain new ar-
rangements or mixtures of the substances which

o

are used to impart a pleasant taste to our ali-
ment ?

13. Should philosophers ever stoop to this sub-
ject, may they not discover and ascertain a table of
the relations of sapid bodies to each other, with
the same accuracy that they have ascertained the
relation of the numerous objects of chemistry to
each other ?

* Dissertations, vol. I. p. 326.

ALIMENTS TO EACH OTHER* 307

14, When the tongue and stomach agree in the
same kinds of aliment, may not the increase of the
pleasure of eating be accompanied with an increase
of health and prolongation of life ?

15. Upon the pleasure of eating, I shall add the
following remarks. In order to render it truly ex-
quisite, it is necessary that all the senses, except
that of taste, should be as quiescent as possible.
Those persons mistake the nature of the appetite
for food, who attempt to whet it by accompanying
a dinner by a band of music, or by connecting the
dining table, with an extensive and delightful pros-
pect. The undue excitement of one sense, always
produces weakness in another. Even conversa-
tion sometimes detracts from the pleasure of eat-
ing : hence great feeders love to eat in silence, or
alone ; and hence the speech of a passionate French-
man, while dining in a talkative company, was not
so improper as might be at first imagined. " Hold
your tongues (said he) ; I cannot taste my dinner."
I know a physician, who, upon the same principle,
always shuts his eyes, and requests silence in a sick
chamber, when he wishes to determine by the pulse
the propriety of blood-letting, in cases where its
indication is doubtful. His perceptions become
.more distinct, by confining his whole attention to
the sense of feeling.

308 THE RELATION OF TASTES, &C

It is impossible to mention the circumstance of
the senses acting only in succession to each other
in the enjoyment of pleasure, without being -struck
with the impartial goodness of Heaven, in placing
the rich and the poor so much upon a level in the
pleasures of the table. Could the numerous ob-
jects of pleasure, which are addressed to the ears
and the eyes, have been possessed at the same time
with the pleasure of eating, the rich would have
commanded three times as much pleasure in that
enjoyment as the poor ; but this is so far from be-
ing the case, that a king has no advantage over a
beggar, in eating the same kind of aliment.

THE

NEW METHOD OF INOCULATING

FOR. THE

SMALL-POX.

DELIVERED IN A LECTURE IN" THE UNIVERSITY OF PENNSYLVA-
NIA, ON THE 2GTH OF FEBRUARY, 1781.

THE NEW METHOD, &?<.

GENTLEMEN,

IT must afford no small pleasure to a bene-
volent mind, in the midst of a war which daily
makes so much havoc with the human species, to
reflect that the small-pox, which once proved
equally fatal to thousands, has been checked in its
career, and in a great degree subdued, by the prac-
tice of INOCULATION.

It is foreign to my purpose to deliver to you
the history of this art, and to mark the various
steps that have attended its progress to its pre-
sent state of improvement. We have yet to la-
ment the want of uniformity and of equal success
in the practice of it among physicians. A great
number of pamphlets have been written upon the
subject without exhausting it. There is still am-

312 NEW METHOD GF INOCULATING

pie room left for the man of genius to exercise his
talents for observation and reasoning upon it. The
facts I mean to lay before you are so inconsider-
able, compared with what still remain to be known
upon this subject, that I have to request, when
your knowledge in it is completed, that you
would bury my name in silence, and forget that
ever I ventured to lay a single stone in this part
of the fabric of science.

In treating upon this subject, I shall

I. Consider the proper subjects, and seasons for
inoculation.

II. I shall describe the method of communicat-
ing the disease.

III. I shall consider the method of preparing
the body for the small-pox.

IV. I shall mention the treatment proper du-
ring the eruptive fever. And,

V. Point out a few cautions that are necessary
after the disease is over.

fOR THE SMALL-POX. 313

I. Formerly there were great difficulties in the
choice of subjects for inoculation. But experience
teaches us, that it may be practised in every stage
of life, and in almost every condition of the human
body. In infancy, the periods before and after
dentition are to be preferred. But we seldom see
any great inconveniences from submitting to the
general necessity of inoculating children between
the ages of three months, and two years. Indeed
we often see children cut three or four teeth during
the preparation and eruptive fever, without the least
addition being made to any of the troublesome
symptoms which accompany the small-pox. There
is one inconvenience attending the choice of the
first months of infancy for inoculating, and that is,
the matter often fails of producing the disease in
such young subjects. I have frequently failed in
two or three attempts to communicate it to chil-
dren under four months old, with the same matter
that has succeeded in a dozen other patients, ino-
culated at the same time. When the inoculation
succeeds in such tender subjects, they generally
have less fever, and fewer pustules, than are com-
mon in any future period of life.

Although a physician would prefer a patient in
good health to any other as a subject for inocula-
tion, yet cases often occur in which it is necessary

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314 NEW METHOD OF INOCULATING

to communicate the small-pox while the body is
affected with some other disease. I can with
pleasure inform you, that the small-pox is rendered
so perfectly safe by inoculation, that there are few
chronic diseases which should be considered as ob-
stacles in the way of it. I have inoculated patients
labouring under a tertian fever, obstructed viscera,
the hooping cough, the hypochondriasis, the asth-
ma, the itch, and other cutaneous diseases, and
even pregnant women, with the same, and, in some
instances, with greater success, than persons in
perfect health. Doctor Cullen informs us, that he
has seen inoculation succeed in scrophuleus pa-
tients. A physician in Jamaica informed me, that
he had inoculated negroes with success in the
worst stage of the yaws. To these facts I must
add one more extraordinary than any that has been
yet mentioned : Doctor Brown, my late colleague
in the care of the military hospitals, informed me,
that he had seen inoculation succeed in patients
who were seized, after the infection was communi-
cated, with the hospital fever. The preparation of
die body should be accommodated to the disease
which affects it. Some physicians have' thought
the small-pox, received in this way, was a remedy
for other diseases ; but my experience has not
confirmed this opinion : on the contrary, I am in-
clined to think that no odier change is produced by

For the small-pox. 315

inoculation, than by the regimen and medicines
that are used to prepare the body for the small-pox.
Nor does the small-pox, during its continuance,
afford any security against the attacks of other dis-
eases. I have seen the most alarming complica-
tion of the small-pox and measles taken in succes-
sion to each other, in the same person.

The seasons commonly preferred for inoculation,
in this country, are the spring and fall. It may be
practised with equal safety in the winter, a due
regard being had to the temperature of the air in
the preparation of the body.

The principal objection to inoculating in the
summer months in this climate, arises from the
frequency of bilious diseases at that season, to
which the preparation necessaiy for the small-pox
probably disposes the body. This caution applies
more directly to children, who, at a certain age,
are more subjeot than grown people to a disease in
their bowels in warm weather,

II. The methods of communicating the small-
pox by inoculation, have been different in different
countries, and in the different seras of its progress
towards its present stage of improvement. The
scab, dossel of lint, and the thread impregnated

4

316 NEW METHOD OF INOCULATING

with variolous matter, and bound up in a gash in
the arm, have been laid aside.

We are indebted to Mr. Sutton for the mode
of communicating it by a slight puncture with the
point of a lancet, or needle, dipt in fresh matter.
As it is difficult sometimes to procure matter in a
fresh state, I have been led to use it with equal
success by preserving it on lint in a box, and
moistening it with cold water just before I used it.
Matter may be kept in this way for a month, with-
out losing its infectious quality, provided it be not
exposed to heat or moisture. The former destroys
its power of infecting as certainly as the salt of
tartar destroys the acidity of vinegar. Moisture,
by remaining long upon the matter, probably de-
stroys its virulence, by subjecting it to fermenta-
tion. The longer matter has been kept in a ge-
neral way, the longer the distance will be between
the time of communicating the disease, and the
eruptive fever. It will be proper always to yield
to the prejudices of our patients in favour of mat-
ter taken from persons who have but few pustules.
But I am persuaded from repeated observations,
that the disease is no ways influenced by this cir-
cumstance. I am satisfied likewise that there is
no difference between the effects of the matter,
whether it be taken in its watery and purulent

TOR THE SMALL-POX. 317

state. The puncture should not be larger than
is sufficient to draw one drop of blood, but it
should always be made by a sharp lancet, for the
sudden inflammation and suppuration, excited by
a dull lancet, sometimes throw off the matter,
so as to prevent its infecting the body*. No
plaster or bandage should be applied over the
puncture. It should be made in the left arm of
all subjects. The objections to inoculating in the
leg are too obvious to be mentioned. I have
heard of the disease being communicated by rub-
bing the dry skin with the matter. My own ob-
servations upon this subject, give me reason to sus-
pect the facts that are contained in books relative
to this mode of infecting the body. I have bound
large pieces of lint dipt in fresh matter for twenty-
four hours upon the arm, without producing the
disease. A practitioner of physic in New- Jersey
informed me, that he once gave a considerable
quantity of fresh variolous matter in a dose of
physic, without infecting his patient. I suspect
the matter that produces the disease is of the same

* I am disposed to believe that the external applications
which are used by the Indians for the cure of the bite of
poisonous snakes act only by exciting inflammation and sup-
puration, which discharge the poison from the wound be-
fore it is absorbed. All their external remedies are of a sti-
mulating nature.

318 NEW METHOD OF INOCULATING

nature wi]th certain poisons, which require to be
brought in contact with a wound or sore in the
body, before they produce their effects. I deliver
this opinion with diffidence. The subject stands
in need of more experiments and investigation.

III. I come now to consider the best method of
preparing the body for the small- pox. This
must be done, 1st, by diet, and 2dly, by medi-
cine. The diet should consist chiefly of vege-
tables. I have never seen any inconvenience from
the free use of milk, as a part of the preparative
diet. In some habits, where a morbid acid pre-
vails in the stomach, we may indulge our patients
in a little weak flesh broth two or three times a
week with safety. A little salted meat may like-
wise be taken daily in such cases. Tea, coffee,
and even weak chocolate, with biscuit or dry toast,
may be used as usual, by persons accustomed to
that kind of aliment. Wine and spirits of all
kinds should be withheld from our patients, during
the preparation. The more acescent their drinks
are, the better. It is unnecessary that this change
in the diet should take place till a day or two be-
fore the time of communicating the disease. The
system accommodates to a vegetable and low diet
in the course of three weeks or a month, so as to
defeat in some measure the advantages we expected

FOR THE SMALL-POX. 319

from it. The good effects of it appear to depend
in a great degree upon the suddenness with which
we oblige our patients to conform to it. For this
reason, when we are called upon to inoculate per-
sons who have lived more than three or four
weeks upon a low diet, we should always direct
them to live a few days upon animal food, before
we communicate the disease to them. By these
means we may produce all the good effects of the
sudden change in the diet I have already mention-
ed. 2. The medicines most commonly used to
prepare the body for the small-pox are antimony
and mercury. The latter has had the preference,
and has been given in large quantifies, under a
notion of its being a specific antidote to the vari-
olous matter. Many objections might be made to
this opinion ; I shall mention only three.

1. We often see the disease in a high degree,
after the system is fully impregnated with mercury.

2. We often see the same salutary effects of
mercury, when given before the disease is commu-
nicated to the body, that we perceive when it is
given after inoculation ; in which case we are sure
the mercury cannot enter into the mixture with the
variolous matter so as to destroy it.

320 NEW METHOD OF INOCULATING

3. If mercury acted specifically in destroying the
variolous matter, it would render every other part
of the preparation unnecessary : but this we know
is not the case, for the neglect or improper use of
the vegetable diet or cool regimen is often attended
with an extraordinary number, or virulence of the
small-pox, even in those cases where mercury is
given in the largest quantity.

The way in which mercury prepares the body
for the small- pox, seems to be by promoting the
several excretions, particularly that by perspiration,
which, by diminishing the quantity of the fluids,
and weakening the tone of the solids, renders the
system less liable to a plentiful eruption of the
small-pox. But I object to the use of this medi*
cine for the following reasons :

1. It effectually deprives us of all the benefits of
the cool regimen ; for mercuiy, we know, always
disposes the system to take cold.

2. All the good effects of mercury may be pro-
duced by purges, which do not subject die body
to the above-mentioned inconvenience.

The purges may be suited to the constitutions,
and in some cases, even to the inclinations of our

FOR THE SMALL-POX. 321

patients. I have seen jalap, rhubarb, senna, man-
na, aloes, soluble tartar, glauber and Epsom salts,
and the butternut pill, all given with equal success.
The quantity should be sufficient to procure three
or four stools every day. A little magnesia should
always be mixed with rhubarb and jalap in pre-
paring children. It will be sufficient for the mo-
thers and nurses of infants to conform strictly to
the vegetable diet. I have never seen any advan-
tages from giving them even a single dose of
physic.

It is hardly necessary to observe, that the qua*
lity, dose, and number of purges are to be deter-
mined by the age, j-ex, and habits of our patients.
A constitution enfeebled by a previous disease
forbids the use of purges, and requires medicines
of a restorative kind. Patients afflicted with cuta-
neous diseases bear larger and more frequent
doses of physic, than are indicated in more healthy
subjects.

In adult subjects of a plethoric habit, blood-
letting is very useful on the third or fourth day
after inoculation. We are not to suppose, that
every fat person labours under a plethora. A mo-
derate degree of fat is so far from rendering the dis-
ease more violent, especially in children, that I

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:322 NEW METHOD OF INOCULATING

think I have generally found such subjects have the
small-pox more favourably than others.

Moderate exercise in the open air should be
used during the preparation. But hard labour,
and every thing that promotes sweat or fatigue,
as also the extremes of heat and cold, should be
avoided.

IV. We come now to consider the treatment of
the body during the eruptive fever. On the eighth
day after inoculation our patients are generally
seized with the common symptoms of fever. Some-
times this fever appears on the sixth and seventh
day after inoculation. But when it is irregular, it
is often delayed till the ninth and tenth days. I
have seen many instances of it on the fourteenth,
a few on the fifteenth and sixteenth, and one case
in which it did not come on till the eighteenth
day after the infection was communicated to the
body*. The place where the puncture was made

* Since the publication of the first edition of this lecture,
I have heard of two cases, in one of which the fever did
not come on till the twentieth, and in the other till the
twenty-first day after the infection was communicated to the
body. In some of these tedious cases, I have seen an inflam-
mation and suppuration on the punctured part of the arm on
the eighth day without any fever. Perhaps in these cases

FOR THE SMALL-POX. 323

with the lancet, or needle, generally serves as a
harbinger of the approaching fever. A slight in-
flammation appears about it, and a pock rises up in
the centre. But this remark is liable to some ob-
jections. I have seen four instances in which the
fever came on at the expected time, and the disease
went through all its stages with the greatest regu-
larity, and yet there was no sign of an inflammation
or pock near the spot where the puncture was
made : even the puncture itself became invisible.
On the other hand, we sometimes see an inflamma-
tion and pock on the arm appear on the eighth and
ninth days, without any fever accompanying them.
Some physicians suppose that this inflammation and
solitary pock are sufficient to constitute the disease;
but repeated experience has taught me to be very
cautious in relying upon these equivocal marks.
It is true, I have sometimes seen patients secured
against the small-pox, both in the natural way and
by inoculation, where these marks have appeared ;
but I have as often seen such patients seized after-
wards with the small-pox in the natural way, to the
great distress of families, and mortification of phy-
sicians. Upon this account, I make it a constant

the inflammation and suppuration are only cuticular, and
that the small-pox is taken from the matter which is formed
by them.

S24 NEW METHOD OF INOCULATING

practice to advise a second or third inoculation,
where a fever and eruption have been wanting.
As the absence of these symptoms is probably
occasioned by the weakness or age of the variolous
matter, or the too high state of preparation of
the body, we should always guard against both,
by making the puncture the second time with fresh
matter, by subjecting our patients to a less abste-
mious diet, and by giving fewer doses of physic.
I have heard it remarked, that if a slight redness
and a small pimple appeared on the arm on the
third day after inoculation, it was a sign the matter
had infected the whole constitution. I acknowledge
I have often seen a greater degree of redness on
the third than on the second day after inoculation,
but I have not been able to establish a diagnostic
mark from it ; for I have seen the disease produced
on the usual days where the redness has appeared
on the second dav, and in some cases where it has
not appeared until the eruptive fever.

I am led here unwillingly to discuss the old ques-
tion, Is it possible to have the small-pox in the
natural way after inoculation ?— In many of the
cases supposed to be the small-pox from inocula-
tion, it is probable the matter has been taken from
the chicken-pox, which resembles the small-pox in
many of its peculiarities, but in none more than that

FOR THE SMALL-POX. 325

i i

of leaving pits or marks on the skin. But there
are certainly cases where there are the most irre-
fragable proofs of the infection implanted by ino-
culation being of a variolous nature, where the
disease has been afterwards taken in the natural
way. In these cases I would suppose the variolous
matter produced only a topical or cuticular dis-
ease. We see something analogous to this in nurses
who attend patients in the small -pox. But fur-
ther, this topical or cuticular infection may be pro-
duced by art in persons who have had the small-
pox in the natural way. Some years ago, I made
a puncture on my left hand with a lancet moistened
with variolous matter. On the eighth day an in-
flammation appeared on the place, accompanied by
an efflorescence in the neighbourhood of it, which
extended about two inches in everv direction from

w

the spot where the puncture was made. On the
eleventh day I was surprised to find two pocks (if
I may venture to call them such), the one on the
outside of the fourth finger of my left hand, and
the other on my forehead. They remained there
for several days, but without filling with matter,
and then dropped off, rather in the form of a soft
wart, than of a common scab. Doctor Way of
Wilmington repeated the same experiment upon
himself, but with an issue to his curiosity more ex-
traordinary than that I have just now related. On

326 NEW METHOD OF INOCULATING

the eighth day after he had made a puncture on
his hand, a pock appeared on the spot, which in
the usual time filled with matter, from which he
inoculated several children, who sickened at the
usual time, and went through all the common stages
and symptoms of the small-pox. It would seem
from these facts, that it is necessary the small-pox
should produce some impression upon the whole
system, in order to render it ever afterwards inca-
pable of receiving an impression of a similar nature.
A fever and an eruption therefore seem necessary
for this purpose. As the inflammation of the arm
on the eighth day is a sign of the topical and cuti-
cular infection, so an eruption (though ever so
small) seems to to be the only certain sign of the
infection of the whole system. The eruption is the
more decisive in its report, in proportion as it
comes out and goes off in the usual manner of the
small-pox in the natural way. In those cases where
patients have been secured against a second attack
of the disease, when there have been no obvious
fever or visible eruption, I think I have observed
an unusual inflammation, and a copious and long
continued discharge of matter from the arm. Per-
haps this may serve as an outlet of the matter,
which in other cases produces the fever and erup-
tion. I am the more disposed to embrace this opi-
nion, from the testimony which several authors

FOR THE SMALL-POX. 327

have left us of the effects of ulcers in securing the
body from the infection of the plague. The effects
of issues are still more to our purpose. We ob-
serve a plentiful discharge of matter from them
every time the body is exposed to cold, and the
febrile effects of it upon the system are thereby
frequently obviated. How far a ratio exists be-
tween the degrees of inflammation and the discharge
of matter from the arm, and the degrees of fever
and eruption, must be determined by future and
very accurate observations. If it should appear,
that there are the least inflammation and smallest
discharge, where there have been the highest fever
and most copious eruption ; and, on the contrary,
if it should appear that there are the greatest inflam-
mation and discharge, where there have been the
least fever and smallest eruption, I must beg leave
to add, without attempting in this place to explain
the reasons of it, that the remark, if generally true,
is liable to some exceptions. But the subject is
involved in darkness ; I shall be satisfied if I have
brought you within sight of the promised land.
Your own ingenuity, like another Jewish leader,
must conduct you thither.

The indications in the treatment of the bodv du-
ring the eruptive fever are,

I. To regulate the degree of fever.

328 NEW METHOD OF INOCULATING

II. To mitigate troublesome and alarming symp-
toms.

The fever which produces the eruption is gene-
rally of the inflammatory kind. It sometimes,
therefore, comes on with the symptoms of great
heat, preceded with chilliness, and determination
to the head and breast, and a full hard pulse. The
remedies proper in this case are,

1. Blood-letting. The quantity to be drawn
must be regulated by the violence of the symp-
toms, the constitution, habits, and even country of
the patient, and by the season of the year. I have
never found more than one bleeding, to the quan-
tity of twelve or fourteen ounces, necessary in any
stage or degree of the eruptive fever of the small-
pox by inoculation.

2. Cool air is of the utmost consequence in the
eruptive fever. The use of this remedy in fevers
marks an sera, not only in the management of the
small-pox, but in medicine. The degrees of cold
should always be increased in proportion to the
violence of the fever. Stove-rooms, so common
in this country, should be carefully avoided. The
more we oblige our patients to sit up and walk in
the open air, the better. Even in those cases where

rOR THE SMALL-POX. 329

they languish most for the bed, they should be
encouraged rather to lie upon, than under the bed-
clothes. Children should be stript of flannel petti-
coats that come in contact with their skins ; and
even clouts should be laid aside, if possible without
great inconvenience, and at any rate they should
be often removed. Great and obvious as the ad-
vantages of cold air appear to be in the eruptive
fever, it has sometimes been used to an excess
that has done mischief. There are few cases where
a degree of cold belew fifty of Fahrenheit's ther-
mometer is necessary in this stage of the small-pox.
When it has been used below this, or where pa-
tients have been exposed to a damp atmosphere
some degrees above it, I have heard of inflamma-
tions of an alarming nature being produced in the
throat and breast.

3. The bowels, more especially of children,
should be kept open with gentle laxatives. And,

4. Cool subacid drinks should be plentifully
used until the eruption be completed.

Sometimes the small-pox comes on with a fever
the reverse of that which we have described. The
heat is inconsiderable, the pulse is weak, and
scarcely quicker than ordinary, and the patient

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330 NEW METHOD OF INOCULATING

complains of but slight pains in the back and head.
Here the treatment should be widely different from
that which has been mentioned when the fever is
of the inflammatory kind. Bleeding in this case
is hurtful, and even cool air must be admitted with
caution. The business of the physician in this case
is to excite a gentle action in the sanguiferous sys-
tem, in order to produce the degree of fever which
is necessary to the eruption of the pock. For this
purpose he may recommend the use of warm
drinks, and even of a warm bed with advantage.
If the eruption delay beyond the third day, with
all the circumstances of debility that have been
mentioned, I have frequently ordered my patients
to eat a few ounces of animal food, and to drink a
glass or two of wine, with the most desirable suc-
cess. The effects of this indulgence are most ob-
vious where the weakness of the fever and the
delay of the eruption in children, have made it
necessary to allow it to mothers and nurses.

The small -pox by inoculation so seldom comes
on with the symptoms of what is called a malignant
fever, that little need be said of the treatment pro-
per in such cases. I shall only observe, that the
cold regimen in the highest degree, promises more
success in these cases than in any others. I have
repeatedly been told, that when the small-pox ap-

FOR THE SMALL-POX. 331

pears confluent among the Africans, it is a com-
mon practice for mothers to rub their children all
over with pepper, and plunge them immediately
afterwards into a spring of cold water. This, they
say, destroys a great part of the pock, and dis-
poses the remainder to a kindly suppuration. From
the success that has attended the use of the cold
bath in malignant fevers in some parts of Europe*,
I am disposed to believe in the efficacy of the Afri-
can remedy.

The fever generally lasts three days, and the
eruption continues for a similar length of time,
counting the last day of the fever, as the first day
of the eruption. But this remark is liable to
many exceptions. We sometimes observe the
eruption to begin on the first, and often on the se-
cond day of the fever ; and we sometimes meet
with cases in which a second eruption comes on
after the fever has abated for several days, and the

* In a dissertation entitled " Efiidemia verna qua Wratisla-
viam, Anno, 1737 afflixit" published in the appendix to the
Acta Nat. Curios. Vol. X. it appears, that washing the body-
all over with cold water in putrid fevers, attended with great
debility, was attended with success at Brtslanv in Silesia,
The practice has since been adopted, we are told, by several
of the neighbouring countries. Cullen's first lines of

THE PRACTICE OF PHYSIC

332 NEW METHOD OF INOCULATING

first eruption considerably advanced in its pro-
gress towards a complete suppuration. This is
often occasioned by the application of excessive
cold or heat to the body, or by a sudden and pre-
mature use of stimulating drinks, or animal food.

I come now to treat of the best method of miti-
gating troublesome and alarming symptoms.

The only alarming symptom is convulsions, to
which children are subject during the time of den-
tition. These have been less frequent, since the
liberal and judicious use of cool air in the eruptive
fever than formerly. They are often relieved by
putting the feet in warm water. But a more ef-
fectual and speedy method of curing them, is to
expose our patients suddenly to the open air. The
colder the air the quicker relief it affords in these
cases. To prevent the return of the fits, as well
as to allay any disagreeable and troublesome start -
ings, a few drops of laudanum should be given.
They generally yield in a little while to this excel-
lent remedy.

The next symptom which demands the aid of
our art, is the inflammation and sore on the arm.
Poultices of all kinds should be laid aside, as tend-
ing to increase the inflammation and sore. Instead

FOR THE SMALL-POX. 333

of these, the part affected should be washed three
or four times a day with cold water*. This appli-
cation is not only agreeable to our patients, but
soon checks the progress of the inflammation, and
disposes the sore to heal about the time the erup-
tion is completed. The eyes should likewise be
washed frequently with cold water, to secure them
from pustules and inflammation. With respect to
those alarming or troublesome symptoms which
occur in those cases where the pocks are nume-
rous, or confluent, they happen so seldom in ino-
culation, that they do not come properly under
our notice in this place. They are moreover fully
discussed by Doctors Boerhaave, Huxham, Hil-
lary, and other practical writers.

V. I come now, in the last place, to deliver a
few directions that are necessary after the eruption
and suppuration are over.

It is well known that eruptions of an obstinate
nature sometimes follow the small-pox. These I
believe are often occasioned by a too sudden and
speedy use of animal food. To guard against these

* Where the inflammation on the arm has been so consi-
derable as not to yield immediately to the application of cold
water, I have used the vegeto-mineral water with advantage.

334 NEW METHOD OF INOCULATING, &C.

disagreeable consequences of inoculation, it is of
the utmost importance to enjoin a cautious and
gradual return to the free use of an animal diet ;
and at the same time it will be necessary to give
our patients a dose or two of purging physic.

Thus, gentlemen, have I delivered to you &
short history of the new method of inoculating for
the small-pox. I am aware that prejudices are
entertained against some parts of it by physicians
of the most ancient name and character among us.
I have witnessed the effects of the old and new me-
thods of preparing the body upon many thousand
patients, and I am satisfied, not only from my own
observations, but from the experience of gentlemen
upon whose judgments I rely more than upon my
own, that the new method is by far the safest and
most successful. Added to this, I can assure my
pupils, that I have never known a single instance
of a patient, prepared and treated in the manner
I have described, that ever had an abscess after the
small-pox, or even such an inflammation or sore
upon the arm as required the application of a poul-
tice.

AN INQUIRY

INTO THE

EFFECTS OF ARDENT SPIRITS

VPON THE

HUMAN BODY AND MIND.

WITH

AN ACCOUNT OF THE MEANS OF PREVENTING,

AND OF THE

REMEDIES FOR CURING tHEM,

AN INQUIRY, &c.

PART I.

BY ardent spirits, I mean those liquors only
which are obtained by distillation from fermented
substances of any kind. To their effects upon the
bodies and minds of men, the following inquiry
shall be exclusively confined. Fermented liquors
contain so little spirit, and that so intimately com-
bined with other matters, that they can seldom be
drunken in sufficient quantities to produce intoxi-
cation, and its subsequent effects, without exciting
a disrelish to their taste, or pain, from their distend-
ing the stomach. They are moreover, when taken
in a moderate quantity, generally innocent, and
often have a friendly influence upon health and life.
vol. i. 2 u

338 ON THE EFFECTS OF

The effects of ardent spirits divide themselves
into such as are of a prompt, and such as are of a
chronic nature. The former discover themselves
in drunkenness, and the latter, in a numerous train
of diseases and vices of the body and mind.

I. I shall begin by briefly describing their
prompt, or immediate effects, in a fit of drunken-
ness.

This odious disease (for by that name it should
be called) appears with more or less of the follow-
ing symptoms, and most commonly in the order
in which I shall enumerate them.

1. Unusual garrulity.

2. Unusual silence.

3. Captiousness, and a disposition to quarrel.

4. Uncommon good humour, and an insipid
simpering, or laugh.

5. Profane swearing, and cursing.

6. A disclosure of their own, or other people's
secrets.

ARDENT SPIRITS. 339

7. A rude disposition to tell those persons in
company, whom they know, their faults.

8. Certain immodest actions. I am sorry to
say, this sign of the first stage of drunkenness, some-
times appears in women, who, when sober, are
uniformly remarkable for chaste and decent man-
ners.

9. A clipping of words.

10. Fighting ; a black eye, or a swelled nose,
often mark this grade of drunkenness.

11. Certain extravagant acts which indicate a
temporary fit of madness. These are singing, hal-
looing, roaring, imitating the noises of brute ani-
mals, jumping, tearing off clothes, dancing naked,
breaking glasses and china, and dashing other ar-
ticles of household furniture upon the ground, or
floor. After a while the paroxysm of drunkenness
is completely formed. The face now becomes
flushed; the eyes project, and are somewhat watery;
winking is less frequent than is natural ; the under
lip is protruded ; the head inclines a little to one
shoulder ; the jaw falls ; belchings and hiccup take
place ; the limbs totter ; the whole body staggers.
The unfortunate subject of this history next falls on

340 ON THE EFFECTS OF

his seat ; he looks around him with a vacant coun-
tenance, and mutters inarticulate sounds to himself.
He attempts to rise and walk ; in this attempt, he
falls upon his side, from which he gradually turns
upon his back. He now closes his eyes, and falls
into a profound sleep, frequently attended with
snoring, and profuse sweats, and sometimes with
such a relaxation of the muscles which confine the
bladder and the lower bowels, as to produce a
symptom which delicacy forbids me to mention.
In this condition, he often lies from ten, twelve,
and twenty-four hours, to two, three, four, and five
days, an object of pity and disgust to his family
and friends. His recovery from this lit of intoxi-
cation is marked with several peculiar appearances.
He opens his eyes, and closes them again ; he
gapes and stretches his limbs ; he then coughs and
pukes ; his voice is hoarse ; he rises with difficul-
ty, and staggers to a chair; his eyes resemble
balls of fire ; his hands tremble ; he loathes the
sight of food ; he calls for a glass of spirits to com-
pose his stomach ; now and then he emits a deep-
fetched sigh, or groan, from a transient twinge of
conscience, but he more frequently scolds, and
curses every thing around him. In this state of
languor and stupidity he remains for two or three
days, before he is able to resume his former habits
of business and conversation.

ARDENT SPIRITS. 341

Pythagoras we are told maintained that the souls
of men after death, expiated the crimes commit-
ted by them in this world, by animating certain
brute animals ; and that the souls of those animals
in their turns, entered into men, and carried with
them all their peculiar qualities and vices. This
doctrine of one of the wisest and best of the Greek
philosophers, was probably intended only to con-
vey a lively idea of the changes which are induced
in the body and mind of man by a fit of drunken-
ness. In folly, it causes him to resemble a calf;
in stupidity, an ass ; in roaring, a mad bull ; in
quarrelling, and fighting, a dog ; in cruelty, a tiger;
in fetor, a skunk ; in filthiness, a hog ; and in ob-
scenity, a he-goat.

It belongs to the history of drunkenness to re-
mark, that its paroxysms occur, like the parox-
ysms of many diseases, at certain periods, and
after longer or shorter intervals. They often
begin with annual, and gradually increase in their
frequency, until they appear in quarterly, monthly,
weekly, and quotidian or daily periods. Finally
they afford scarcely any marks of remission, either
during the day or the night. There was a citizen
of Philadelphia, many years ago, in whom drunk-
enness appeared in this protracted form. In speak-
ing of him to one of his neighbours, I said,

342 ON THE EFFECTS OF

" Does he not sometimes get drunk?" " You
mean," said his neighbour, " is he not sometimes
sober?"

It is further remarkable, that drunkenness re-
sembles certain hereditary, family, and contagi-
ous diseases. I have once known it to descend
from a father to four out of five of his children.
I have seen three, and once four brothers who were
born of sober ancestors, affected by it, and I have
heard of its spreading through a whole family
composed of members not originally related to
each other. These facts are important, and should
not be overlooked by parents, in deciding upon
the matrimonial connections of their children.

Let us next attend to the chronic effects of ar-
dent spirits upon the body and mind. In the bo-
dy, they dispose to every form of acute disease ;
they moreover excite fevers in persons predisposed
to them, from other causes. This has been re-
marked in all the yellow fevers which have visit-
ed the cities of the United States. Hard drinkers
seldom escape, and rarely recover from them.
The following diseases are the usual consequences
of the habitual use of ardent spirits, viz.

ARDENT SPIRITS. 343

1. A decay of appetite, sickness at stomach,
and a puking of bile, or a discharge of a frothy
and viscid phlegm by hawking, in the morning.

2. Obstructions of the liver. The fable of
Prometheus, on whose liver a vulture was said to
prey constantly, as a punishment for his stealing fire
from heaven, was intended to illustrate the painful
effects of ardent spirits upon that organ of the
body.

3. Jaundice and dropsy of the belly and limbs,
and finally of every cavity in the body. A swell-
ing in the feet and legs is so characteristic a mark
of habits of intemperance, that the merchants in
Charleston, I have 'been told, cease to trust the
planters of South- Carolina, as soon as they perceive
it. They very naturally conclude industry and
virtue to be extinct in that man, in whom that
symptom of disease has been produced by the in-
temperate use of distilled spirits.

4. Hoarseness, and a husky cough, which often
terminate in consumption, and sometimes in an
acute and fatal disease of the lungs.

5. Diabetes, that is, a frequent and weakening
discharge of pale, or sweetish urine.

s

344 ON THE EFFECTS OF

6. Redness and eruptions on different parts of
the body. They generally begin on the nose, and
after gradually extending all over the face, some-
times descend to the limbs in the form of leprosy.
They have been called " rum- buds," when they
appear in the face. In persons who have occa-
sionally survived these effects of ardent spirits on
the skin, the face after a while becomes bloated,
and its redness is succeeded by a death-like pale-
ness. Thus the same fire which produces a red
colour in iron, when urged to a more intense de-
gree, produces what has been called a white heat.

7. A fetid breath, composed of every thing that
is offensive in putrid animal matter.

8. Frequent and disgusting belchings. Dr.
Haller relates the case of a notorious drunkard
having been suddenly destroyed, in consequence of
the vapour discharged from his stomach by belch-
ing, accidentally taking fire by coming in contact
with the flame of a candle.

9. Epilepsy.

10. Gout, in all its various forms of swelled
limbs, colic, palsy, and apoplexy.

ARDENT SPIRITS, 345

Lastly, 11. Madness. The late Dr. Waters,
while he acted as house pupil and apothecary of
the Pennsylvania hospital, assured me, that in one-
third of the patients confined by this terrible dis-
ease, it had been induced by ardent spirits. .

Most of the diseases which have been enume-
rated are of a mortal nature. They are more cer-
tainly induced, and terminate more speedily in
death, when spirits are taken in such quantities,
and at such times, as to produce frequent intoxi-
cation : but it may serve to remove an error with
which some intemperate people console themselves,
to remark, that ardent spirits often bring on fatal
diseases without producing drunkenness. I have
known many persons destroyed by them, who
were never completely intoxicated during the whole
course of their lives. The solitary instances of
longevity which are now and then met with in
hard drinkers, no more disprove the deadly effects
of ardent spirits, than the solitary instances of re-
coveries from apparent death by drowning, prove
that there is no danger to life from a human body
lying an hour or two under water.

The body after its death, from the use of dis-
tilled spirits, exhibits by dissection certain appear-
ances which are of a peculiar nature. . The fibres

vol. K 2 x

346 ON THE EFFECTS OF

of the stomach and bowels are contracted ; ab-
scesses, gangrene, and schirri are found in the
viscera ; the bronchial vessels are contracted ; the
blood-vessels and tendons, in many parts of the
body, are more or less ossified ; and even the hair
of the head possesses a crispness which renders it
less valuable to wig-makers than the hair of sober
people.

Not less destructive are the effects of ardent spi-
rits upon the human mind. They impair the
memory, debilitate the understanding, and per-
vert the moral faculties. It was probably from
observing these effects of intemperance in drink-
ing, upon the mind, that a law was formerly pass-
ed in Spain, which excluded drunkards from being
witnesses in a court of justice. But the demoral-
izing effects of distilled spirits do not stop here.
They produce not only falsehood, but fraud, theft,
uncleanliness, and murder. Like the demoniac
mentioned in the New Testament, their name is
" legion,'' for they convey into the soul, a host of
vices and crimes.

A more affecting spectacle cannot be exhibited,
than a person into whom this infernal spirit, gene-
rated by habits of intemperance, has entered. It
is more or less affecting, according to the statio»

ARDENT SPIRITS. 34?

the person fills in a family, or in society, who is
possessed by it. Is he a husband ? How deep the
anguish which rends the bosom of his wife ! Is
she a wife ? Who can measure the shame and
aversion which she excites in her husband ! Is he
tie father, or is she the mother of a family of
Children ? See their averted looks from their pa-
rent, and their blushing looks at each other ! Is
he a imo-istrate? or has he been chosen to fill a
high and respectable station in the councils of his
country? What humiliating fears of corruption
in the administration of the laws, and of the sub-
version of public order and happiness, appear in
the countenances of all who see him ! Is he a
minister of the gospel ? Here language fails me.

If angels weep, — it is at such a sight.

i
In pointing out the evils produced by ardent
spirits, let us not pass by their effects upon the
estates of the persons who are addicted to them.
Are they inhabitants of cities ? Behold their houses
stripped gradually of their furniture, and pawned,
or sold by a constable, to pay tavern debts ! See
their names upon record in the dockets of every
court, and whole pages of newspapers filled with
advertisements of their estates for public sale ! Are
they inhabitants of country places ? Behold their
houses with shattered windows ! their barns with

348 ON THE EFFECTS OF

leaky roofs ! their gardens over-run with weeds !
their fields with broken fences ! their hogs without
yokes ! their sheep without wool ! their cattle and
horses without fat ! and their children filthy, and
half clad, without manners, principles, and morals?
This picture of agricultural wretchedness is seldom
of long duration. The farms and property thus
neglected, and depreciated, are seized and sold for
the benefit of a groupe of creditors. The children
that were born with the prospect of inheriting
them, are bound out to service in the neighbour-
hood; while their parents, the unworthy authors
of their misfortunes, ramble into new and distant
settlements, alternately fed on their way by the hand
of charity, or a little casual labour.

Thus we see poverty and misery, crimes and
infamy, diseases and death, are all the natural and
usual consequences of the intemperate use of ar-
dent spirits.

I have classed death among the consequences of
hard drinking* But it is not death from the imme-
diate hand of the Deity, nor from any of the instru-
ments of it which were created by him. It is
death from suicide. Yes! thou poor degraded
creature, who art daily lifting the poisoned bowl
t© thy lips, cease to avoid the unhallowed ground

ARDENT SPIRITS. 349

in which the self-murderer is interred, and wonder
no longer that the sun should shine, and the rain
fall, and the grass look green upon his grave.
Thou art perpetrating gradually, by the use of ar-
dent spirits, what he has effected suddenly, by
opium, or a halter. Considering how many cir-
cumstances, from a sudden gust of passion, or
from derangement, may palliate his guilt, or that
(unlike yours) it was not preceded and accompa-
nied by any other crime, it is probable his con-
demnation will be less than yours at the day of
judgment.

I shall now take notice of the occasions and cir-
cumstances which are supposed to render the use
of ardent spirits necessary, and endeavour to show
that the arguments in favour of their use in such
cases are founded in error, and that, in each of
them, ardent spirits, instead of affording strength
to the body, increase the evils they are intended to
relieve.

1. They are said to be necessary in very cold
weather. This is far from being true ; for the
temporary warmth they produce, is always suc-
ceeded by a greater disposition in the body to be
affected by cold. Warm dresses, a plentiful meal
just before exposure to the cold, and eating occa-

350 ON THE EFFECTS OF

sionally a little gingerbread, or any other cordial
food, is a much more durable method of preserv-
ing the heat of the body in cold weather.

2. They are said to be necessary in very warm
weather. Experience proves that they increase
instead of lessening the effects of heat upon the
body, and thereby dispose to diseases of all kinds.
Even in the warm climate of the West- Indies,
Dr. Bell asserts this to be true. " Rum (says this
author) whether used habitually, moderately, or
in excessive quantities, in the West- Indies, always
diminishes the strength of the body, and renders
men more susceptible of disease, and unfit for any
service in which vigour or activity is required*."
As well might we throw oil into a house, the roof
of which was on fire, in order to prevent the flames
from extending to its inside, as pour ardent spirits
into the stomach, to lessen the effects of a hot sun
upon the skin.

3. Nor do ardent spirits lessen the effects of
hard labour upon the body. Look at the horse :
with every muscle of his body swelled from morn-
ing till night In the plough, or a team, does he

* Inquiry into the causes which produce, and the means
of preventing diseases among British officers, soldiers, and
others in the West-Indies.

ARDENT SPIRITS. 351

make signs for a draught of toddy or a glass of
spirits, to enable him to cleave the ground, or to
climb a hill ? No ; he requires nothing but cool
water, and substantial food. There is no nourish-
ment in ardent spirits. The strength they pro-
duce in labour is of a transient nature, and is al-
ways followed by a sense of weakness and fatigue.

But are there no conditions of the human body
in which ardent spirits may be given ? I answer,
there are. 1st. When the body has been suddenly
exhausted of its strength, and a disposition to faint-
ness has been induced. Here a few spoonsful, or
a wine-glassful of spirits, with or without water,
may be administered with safety and advantage.
In this case we comply strictly with the advice of
Solomon, who restricts the use of " strong drink"
only " to him who is ready to perish." 2dly.
When the body has been exposed for a long time
to wet weather, more especially if it be combined
with cold. Here a moderate quantity of spirits is
not only safe, but highly proper to obviate debility,
and to prevent a fever. They will more certainly
have those salutary effects, if the feet are at the
same time bathed with them, or a half pint of them
poured into the shoes or boots. These I believe
are the only two cases in which distilled spirits are
useful or necessary to persons in health.

AN INQUIRY, &c.

PART IL

BUT it may be said, if we reject spirits
from being a part of our drinks, what liquors shall
we substitute in their room ? I answer, in the first
place,

1. Simple water. I have known many in-
stances of persons who have followed the most
laborious employments for many years in the
open air, and in warm and cold weather, who
never drank any thing but water, and enjoyed
uninterrupted good health. Dr. Moseley, who
resided many years in the West- Indies, confirms
this remark. " I aver (says the doctor), from
my own knowledge and custom, as well as the
custom and observations of many other people,

vol. r. 2 y

354 ON THE EFFECTS OF

that those who drink nothing but water, or make
it their principal drink, are but little affected by
the climate, and can undergo the greatest fatigue
without inconvenience, and are never subject to
troublesome or dangerous diseases."

Persons who are unable to relish this simple be-
verage of nature, may drink some one, or of all
the following liquors, in preference to ardent spi-
rits.

2. Cyder. This excellent liquor contains a
small quantity of spirit, but so diluted, and blunt-
ed by being combined with a large quantity of sac-
charine matter, and water, as to be perfectly
wholesome. It sometimes disagrees with persons
subject to the rheumatism, but it may be made
inoffensive to such people, by extinguishing a red
hot iron in it, or by mixing it with water. It is
to be lamented, that the late frosts in the spring-
so often deprive us of the fruit which affords this
liquor. The effects of these frosts have been in
some measure obviated by giving an orchard a
north-west exposure, so as to check too early ve-
getation, and by kindling two or three large
fires of brush or straw, to the windward of the or-
chard, the evening before we expect a night of
frost. This last expedient has in many instances

ARDENT SPIRITS. 355

preserved the fruit of an orchard, to the great
joy and emolument of the ingenious husbandman.

3. Malt liqjjors. The grain from which
these liquors are obtained, is not liable, like the
apple, to be affected by frost, and therefore they
can be procured at all times, and at a mode-
rate price. They contain a good deal of nou-
rishment ; hence we find many of the poor peo-
ple in Great-Britain endure hard labour with no
other food than a quart or three pints of beer,
with a few pounds of bread in a day. As it will
be difficult to prevent small beer from becoming
sour in warm weather, an excellent substitute may
be made for it by mixing bottled porter, ale, or
strong beer with an equal quantity of water ; or a
pleasant beer may be made by adding to a bottle
of porter, ten quarts of water, and a pound of
brown sugar, or a pint of molasses. After they
have been well mixed, pour the liquor into bot-
tles, and place them, loosely corked, in a cool cel-
lar. In two or three days, it will be fit for use.
A spoonful of ginger added to the mixture, renders
it more lively, and agreeable to the taste.

3. Wines. These fermented liquors are com-
posed of the same ingredients as cyder, and are
both cordial and nourishing. The peasants of

356 ON THE EFFECTS OT

France, who drink them in large quantities, are
a sober and healthy body of people. Unlike ar^
dent spirits, which render the temper irritable,
wines generally inspire cheerfulness and good hu-
mour. It is to be lamented that the grape has
not as yet been sufficiently cultivated in our coun-
try, to afford wine to our citizens ; but many ex-
cellent substitutes may be made for it, from the
native fruits of all the states. If two barrels of
cyder fresh from the press, are boiled into one,
and afterwards fermented, and kept for two or
three years in a dry cellar, it affords a liquor
which, according to the quality of the apple from
which the cyder is made, has the taste of Mala-
ga, or Rhenish wine. It affords when mixed with
water, a most agreeable drink in summer. I have
taken the liberty of calling it Pomona wine.
There is another method of making a pleasant
wine from the apple, by adding four and twenty
gallons of new cyder to three gallons of syrup
made from the expressed juice of sweet apples.
When thoroughly fermented, and kept for a few
years, it becomes fit for use. The blackberry
of our fields, and the raspberry and currant of
our gardens, afford likewise an agreeable and
wholesome wine, when pressed and mixed with
certain proportions of sugar and water, and a lit-
tie spirit, to counteract their disposition to an ex-

ARDENT SPIRITS, 357

eessive fermentation. It is no objection to these
cheap and home-made wines, that they are unfit
for use until they are two or three years old. The
foreign wines in common use in our country, re-
quire not only a much longer time to bring them
to perfection, but to prevent their being disagreea-
ble, even to the taste.

4. Molasses and water, also vinegar and
water, sweetened with sugar or molasses, form an
agreeable drink in warm weather. It is pleasant
and cooling, and tends to keep up those gentle and
uniform sweats, on which health and life often de-
pend. Vinegar and water constituted the only
drink of the soldiers of the Roman republic, and it
is well known they marched and fought in a warm
climate, and beneath a load of arms which weighed
sixty pounds. Boaz, a wealthy farmer in Pales-
tine, we find treated his reapers with nothing but
bread dipped in vinegar. To such persons as ob-
ject to the taste of vinegar, sour milk, or butter-
milk, or sweet milk diluted with water, may be
given in its stead. I have known the labour of
the longest and hottest days in summer supported,
by means of these pleasant and wholesome drinks,
with great firmness, and ended, with scarcely a
complaint of fatigue.

3o8 ON THE EFFECTS OF

5. The sugar maple affords a thin juice, which
has long been used by the farmers in Connecticut,
as a cool and refreshing drink, in the time of har-
vest. The settlers in the western counties of the
middle states will do well to let a few of the trees
which yield this pleasant juice remain in all their
fields. They may prove the means, not only of
saving their children and grand- children many
hundred pounds, but of saving their bodies from
disease and death, and their souls from misery be-
vond the grave.

6. Coffee possesses agreeable and exhilarating
qualities, and might be used with great advantage
to obviate the painful effects of heat, cold, and fa-
tigue upon the body. I once knew a country phy-
sician, who made it a practice to drink a pint of
strong coffee previously to his taking a long or cold
ride. It was more cordial to him than spirits, in
any of the forms in which they are commonly used.

The use of the cold bath in the morning, and
of the warm bath in the evening, are happily cal-
culated to strengthen the body in the former part
of the day, and to restore it in the latter, from the
languor and fatigue which are induced by heat
and labour.

ARDENT SPIRITS. 359

Let it not be said, ardent spirits have become
necessary from habit in harvest, and in other sea-
sons of uncommon and arduous labour. The ha-
bit is a bad one, and may be easily broken. Let
but half a dozen farmers in a neighbourhood com-
bine to allow higher wages to their labourers than
are common, and a sufficient quantity of any of
the pleasant and wholesome liquors I have recom-
mended, and they may soon, by their example,
abolish the practice of giving them spirits. In a
little while they will be delighted with the good
effects of their association. Their grain and hay
will be gathered into their barns in less time, and
in a better condition than formerly, and of course
at a less expense, and a hundred disagreeable
scenes from sickness, contention, and accidents
will be avoided, all of which follow in a greater or
less degree the use of ardent spirits.

Nearly all diseases have their predisposing caus-
es. The same thing may be said of the intem-
perate use of distilled spirits. It will, therefore,
be useful to point out the different employments,
situations, and conditions of the body and mind,
which predispose to the love of those liquors, and
to accompany them with directions to prevent per-
sons being ignorantly and undesignedly seduced
into the habitual and destructive use of them.

360 ON THE EFFECTS OF

1. Labourers bear with great difficulty, long in-
tervals between their meals. To enable them to
support the waste of their strength, their stomachs
should be constantly, but moderately stimulated
by aliment, and this is best done by their eating
four or five times in a day during the seasons of
great bodily exertion. The food at this time should
be solid, consisting chiefly of salted meat. The
vegetables used with it, should possess some acti-
vity, or they should be made savouiy by a mixture
of spices. Onions and garlic are of a most cordial
nature. They composed a part of the diet which
enabled the Israelites to endure, in a warm climate,
the heavy tasks imposed upon them by their Egyp-
tian masters; and they were eaten, Horace and
Virgil tell us, by the Roman farmers, to repair the
waste of their strength, by the toils of harvest.
There are likewise certain sweet substances, which
support the body under the pressure of labour.
The negroes in the West- Indies become strong,
and even fat, by drinking the juice of the sugar
cane, in the season of grinding it. The Jewish
soldiers were invigorated by occasionally eating
raisins and figs. A bread composed of wheat
flour, molasses, and ginger (commonly called gin-
gerbread), taken in small quantities during the day,
is happily calculated to obviate the debility induced
upon the body by constant labour. All these sub-

ARDENT SPIRITS. 361

stances, whether of an animal or vegetable nature,
lessen the desire, as well as the necessity, for cor-
dial drinks, and impart equable and durable strength
to every part of the system.

2. Valetudinarians, especially those who are
afflicted with diseases of the stomach and bowels,
are very apt to seek relief from ardent spirits. Let
such people be cautious how they make use of this
dangerous remedy. I have known many men and
women of excellent characters and principles, who
have been betrayed, by occasional doses of gin and
brandy, into a love of those liquors, and have after-
wards fallen sacrifices to their fatal effects. The
different preparations of opium are much more safe
and efficacious than distilled cordials of any kind,
in flatulent or spasmodic affections of the stomach
and bowels. So great is the danger of contracting
a love for distilled liquors, by accustoming the sto-
mach to their stimulus, that as few medicines as
possible should be given in spiritous vehicles, in
chronic diseases. A physician, of great eminence
and uncommon worth, who died towards the close
of the last century, in London, in taking leave of a
young physician of this city, who had finished his
studies under his patronage, impressed this caution
with peculiar force upon him, and lamented at the
same time, in pathetic terms, that he had innocent-

vol. i. 2 z

362 ON THE EFFECTS OF

ly made many sots, by prescribing brandy and wa-
ter in stomach complaints. It is difficult to tell
how many persons have been destroyed by those
physicians who have adopted Dr. Brown's indiscri-
minate practice in the use of stimulating remedies,
the most popular of which is ardent spirits, but,
it is well known, several of them have died of in-
temperance in tiiis city, since the year 1790. They
were probably led to it, by drinking brandy and
water, to relieve themselves from the frequent at-
tacks of debility and indisposition, to which the la-
bours of a physician expose him, and for which
rest, fasting, a gentle purge, or weak diluting
drinks would have been safe and more certain
cures.

None of these remarks are intended to preclude
the use of spirits in the low state of short, or what
are called acute diseases, for, in such cases, they
produce their effects too soon to create a habitual
debire for them.

3. Some people, from living in countries subject
to intermitting fevers, endeavour to fortify them-
selves against them, by taking two or three wine-
glasses oi bitters, made with spirits, every day.
There is great danger of contracting habits of in-
temperance from this practice. Besides, this

ARDENT SPIRITS. 363

mode of preventing intermittents is far from being
a certain one. A much better security against
them, is a tea- spoonful of the Jesuits bark, taken
every morning during a sickly season. If this
safe and excellent medicine cannot be had, a gill or
half a pint of a strong watery infusion of centaury,
camomile, wormwood, or rue, mixed with a little
of the calamus of our meadows, may be taken eve-*
ry morning, with nearly the same advantage as the
Jesuits bark. Those persons who live in a sickly
country, and cannot procure any of the preventives
of autumnal fevers which have been mentioned,
should avoid the morning and evening air ; should
kindle fires in their houses, on damp days, and in
cool evenings, throughout the whole summer ; and
put on winter clothes, about the first week in Sep-
tember. The last part of these directions applies
only to the inhabitants of the middle states.

4. Men who follow professions, which require
constant exercise of the faculties of their minds,
are very apt to seek relief, by the use of ardent spi-
rits, from the fatigue which succeeds great mental
exertions. To such persons, it may be a discovery
to know, that tea is a much better remedy for
that purpose. By its grateful and gentle stimulus,
it removes fatigue, restores the excitement of the
"mind, and invigorates the whole system. I am

554 ON THE EFFECTS OF

no advocate for the excessive use of tea. When
taken too stroif^, it is hurtful, especially to the fe-
male constitution ; but when taken of a moderate
degree of strength, and in moderate quantities, with
sugar and cream, or milk, I believe it is, in gene-
ral, innoxious, and at all times to be preferred to
ardent spirits, as a cordial for studious men. The
late Anthony Benezet, one of the most laborious
schoolmasters I ever knew, informed me, he had
been prevented from the love of spiritous liquors,
by acquiring a love for tea in early life. Three or
four cups, taken in an afternoon, carried off the
fatigue of a whole day's labour in his school. This
worthy man lived to be seventy-one years of age,
and died of an acute disease, with the full exercise
of all the faculties of his mind. But the use of tea
counteracts a desire for distilled spirits, during
great bodily > as well as mental exertions. Of this,
Captain Forest has furnished us with a recent and
remarkable proof, in his History of a Voyage from
Calcutta, to the Marqui Archipelago. " I have
always observed (says this ingenious mariner) when
sailors drink tea, it weans them from the thoughts
of drinking strong liquors, and pernicious grog;
and with this, thev are soon contented. Not so
with whatever will intoxicate, be it what it will.
This has always been my remark. I therefore
always encourage it, without their knowing why."

([

ARDENT SPIRITS. 365

5. Women have sometimes been led to seek re-
lief from what is called breeding sickness, by the
use of ardent spirits. A little gingerbread, or
biscuit, taken occasionally, so as to prevent the
stomach being empty, is a much better remedy for
that disease.

6. Persons under the pressure of debt, disap-
pointments in worldly pursuits, and guilt, have
sometimes sought to drown their sorrow s in strong
drink. The only radical cure for those evils, is
to be found in religion ; but where its support is
not resorted to, wine and opium should always be
preferred to ardent spirits. They are far less inju-
rious to the body and mind, than spirits, and the
habits of attachment to them are easily broken,
after time and repentance have removed the evils
they were taken to relieve.

7. The sociable and imitative nature of man,
often disposes him to adopt the most odious and
destructive practices from his companions. The
French soldiers who conquered Holland, in the
year 1794, brought back with them the love and
use of brandy, and thereby corrupted the inhabi-
tants of several of the departments of France, who
had been previously distinguished for their tempe-
rate and sober manners. Many other facts might

366 ON THE EFFECTS OF

be mentioned, to show how important it is to avoid
the company of persons addicted to the use of ar-
dent spirits.

8. Smoking and chewing tobacco, by rendering
water and simple liquors insipid to the taste, dis-
pose very much to the stronger stimulus of ardent
spirits. The practice of smoking segars has, in
every part of our country, been more followed by
a general use of brandy and water, as a common
drink, more especially by that class of citizens who
have not been in the habit of drinking wine, or
malt liquors. The less, therefore, tobacco is used
in the above ways, the better.

9. No man ever became suddenly a drunkard.
Jt is by gradually accustoming the taste and sto-
mach to ardent spirits, in the forms of grog and
toddy, that men have been led to love them in
their more destructive mixtures, and in their sim-
ple state. Under the impression of this truth,
were it possible for me to speak with a voice so
loud as to be heard from the river St. Croix to the
remotest shores of the Mississippi, which bound
the territory of the United States, I would say,
Friends and fellow-citizens, avoid the habitual use
of those two seducing liquors, whether they be
made with brandy, rum, gin, Jamaica spirits, whis-

ARDENT SPIRITS. 367

key, or what is called cherry bounce. It is true,
some men, by limiting the strength of those drinks,
by measuring the spirit and water, have drunken
them for many years, and even during a long life,
without acquiring habits of intemperance or in-
toxication, but many more have been insensibly
led, by drinking weak toddy and grog first at their
meals, to take them for their constant drink, in the
intervals of their meals ; afterwards to take them,
of an increased strength, before breakfast in the
morning ; and finally to destroy themselves by
drinking undiluted spirits, during every hour of
the day and night. I am not singular in this re-
mark. " The consequences of drinking rum and
water, or grog, as it is called (says Dr. Moseley),
is, that habit increases the desire of more spirits,
and decreases its effects ; and there are very few
grog- drinkers who long survive the practice of de-
bauching with it, without acquiring the odious nui-
sance of dram-drinkers' breath, and downright stu-
pidity and impotence*." To enforce the caution
against the use of those two apparently innocent
and popular liquors still further, I shall select one
instance, from among many, to show the ordinary
manner in which they beguile and destroy their
votaries. A citizen of Philadelphia, once of a fair

* Treatise on Tropical Diseases-.

368 ON THE EFFECTS OF

and sober character, drank toddy for many years,
as his constant drink. From this he proceeded to
drink grog. After a while, nothing would satisfy
him but slings made of equal parts of rum and wa-
ter, with a little sugar. From slings he advanced
to raw rum, and from common rum to Jamaica
spirits. Here he rested for a few months, but at
length, finding even Jamaica spirits were not strong
enough to warm his stomach, he made it a constant
practice to throw a table- spoonful of ground pep-
per in each glass of his spirits, in order, to use his
own words, u to take off their coldness." He soon
after died a martyr to his intemperance.

Ministers of the gospel, of every denomination,
in the United States ! aid me with all the weight
you possess in society, from the dignity and useful-
ness of your sacred office, to save our fellow men
from being destroyed, by the great destroyer of
their lives and souls. In order more successfully
to effect this purpose, permit me to suggest to you
to employ the same wise modes of instruction,
which you use in your attempts to prevent their
destruction by other vices. You expose the evils
of covetousness, in order to prevent theft ; you
point out the sinfulness of impure desires, in order
to prevent adultery ; and you dissuade from an-
ger, and malice, in order to prevent murder. In

ARDENT SPIRITS* 369

like maimer, denounce, by your preaching, con-
versation, and examples, the seducing influence of
toddy and grog, when you aim to prevent all the
crimes and miseries, which are the offspring of
strong drink ,

We have hitherto considered the effects of ar-
dent spirits upon individuals, and the means of
preventing them. I shall close this head of our
inquiry, by a few remarks on their effects upon
the population and welfare of our country, and the
means of obviating them.

It is highly probable, not less than 4000 people
die annually, from the use of ardent spirits, in the
United States. Should they continue to exert this
deadly influence upon our population, where will
their evils terminate ? This question may be an-
swered, by asking, where are all the Indian tribes,
whose numbers and arms formerly spread terror
among their civilized neighbours ? I answer, in the
words of the famous Mingo chief, " the blood of
many of them flows not in the veins of any human
creature." They have perished, not by pesti-
lence, nor war, but by a greater foe to human
,life than either of them — ardent spirits. The
loss of 4000 American citizens, by the yellow fe-
ver, in a single year, awakened general sympathy

vol. it 3 a

370 ON THE EFFECTS OF

and terror, and called forth all the strength and
ingenuity of laws, to prevent its recurrence. Why-
is not the same zeal manifested in protecting our
citizens from the more general and consuming ra-
vages of distilled spirits ? Should the customs of
civilized life, preserve our nation from extinction,
and even from an increase of mortality, by those
liquors ; they cannot prevent our country being
governed by men, chosen by intemperate and
corrupted voters. From such legislators, the
republic would soon be in danger. To avert
this evil, let good men of every class unite and
besiege the general and state governments, with
petitions to limit the number of taverns ; to impose
heavy duties upon ardent spirits ; to inflict a mark
of disgrace, or a temporary abridgment of some
civil right, upon every man convicted of drunken-
ness ; and finally to secure the property of habitual
drunkards, for the benefit of their families, by
placing it in the hands of trustees, appointed for
that purpose, by a court of justice.

To aid the operation of these laws, would it
not be extremely useful for the rulers of the dif-
ferent denominations of christian churches to unite,
and render the sale and consumption of ardent
spirits, a subject of ecclesiastical jurisdiction?
The methodists, and society of friends, have, for

ARDENT SPIRITS. 371

some time past, viewed them as contraband arti-
cles, to the pure laws of the gospel, and have borne
many public and private testimonies, against mak-
ing them the objects of commerce. Their success
in this benevolent enterprise, affords ample encou-
ragement for all other religious societies to follow
their example.

AN INQUIRY, &c.

PART III.

WE come now to the third part of this in-
quiry, that is, to mention the remedies for the evils
which are brought on by the excessive use of dis-
tilled spirits.

These remedies divide themselve into two
kinds.

I. Such as are proper to cure a fit of drunken*
ness, and

II. Such as are proper to prevent its recurrence,
and to destroy a desire for ardent spirits.

374 ON THE EFFECTS OF

I. I am aware that the efforts of science and hu-
manity, in applying their resources to the cure of
a disease, induced by an act of vice, will meet with
a cold reception from many people. But let such
people remember, the subjects of our remedies, are
their fellow creatures, and that the miseries brought
upon human nature, by its crimes, are as much the
objects of divine compassion (which we are bound
to imitate), as the distresses which are brought
upon men, by the crimes of other people, or which
they bring upon themselves, by ignorance or acci-
dents. Let us not then, pass by the prostrate suf-
ferer from strong drink, but administer to him the
same relief, we would afford to a fellow creature, in
a similar state, from an accidental, and innocent
cause.

1. The first thing to be done to cure a fit of
drunkenness, is to open the collar, if in a man, and
remove all tight ligatures from every other part of
the body. The head and shoulders should at the
same time be elevated, so as to favour a more feeble
determination of the blood to the brain.

2. The contents of the stomach should be dis-
charged, by thrusting a feather down the throat. It
often restores the patient immediately to his senses
and feet. Should it fail of exciting a puking,

ARDENT SPIRITS. 375

3. A napkin should be wrapped round the head,
and wetted for an hour or two with cold water,
or cold water should be poured in a stream upon
the head. In the latter way, I have sometimes seen
it used, when a boy, in the city of Philadelphia.
It was applied, by dragging the patient, when
found drunk in the street, to a pump, and pump-
ing water upon his head for ten or fifteen minutes.
The patient generally rose, and walked off, sober
and sullen, after the use of this remedy.

Other remedies, less common, but not less ef-
fectual for a fit of drunkenness, are,

4. Plunging the whole body into cold water.
A number of gentlemen who had drunken to in-
toxication, on board a ship in the stream, near
Fell's point, at Baltimore, in consequence of their
reeling in a small boat, on their way to the shore,
in the evening, overset it, and fell into the water.
Several boats from the shore hurried to their relief.
They were all picked up, and went home, perfectly
sober, to their families.

5. Terror. A number of young merchants, who
had drunken together, in a compting-house, on
James river, above thirty years ago, until they were
intoxicated, were carried away by a sudden rise of

376 ON THE EFFECTS OF

the river, from an immense fall of rain. They
floated several miles with the current, in their littie
cabin, half filled with water. An island in the river
arrested it. When they reached the shore that
saved their lives, they were all sober. It is proba-
ble terror assisted in the cure of the persons who
fell into the water at Baltimore.

6. The excitement of a fit of anger. The late
Dr. Witherspoon used to tell a story of a man in
Scotland, who was always cured of a fit of drunk-
enness, by being made angry. The means chosen
for that purpose, was a singular one. It was talk-
ing against religion.

7. A severe whipping. This remedy acts by
exciting a revulsion of the blood from the brain, to
the external parts of the body.

8. Profuse sweats. By means of this evacua-
tion, nature sometimes cures a fit of drunkenness.
Their good effects are obvious in labourers, whom
quarts of spirits taken in a day, will seldom intoxi-
cate, while they sweat freely. If the patient be
unable to swallow warm drinks, in order to produce
sweats, they may be excited by putting him in a
warm bath, or wrapping his body in blankets, un-

ARDENT SPIRITS. 377

rler which should be placed half a dozen hot bricks,
or bottles filled with hot water.

9. Bleeding. This remedy should always be
used, when the former ones have been prescribed
to no purpose, or where there is reason to fear from
the long duration of the disease, a material injury
may be done to the brain.

*

It is hardly necessary to add, that each of the
above remedies, should be regulated by the grade
of drunkenness, and the greater or less degree, in
which the intellects are affected in it.

II. The remedies which are proper to prevent the
recurrence of fits of drunkenness, and to destroy the
desire for ardent spirits, are religious, metaphysical,
and medical. I shall briefly mention them.

r

1. Many hundred drunkards have been cured of
their desire for ardent spirits, by a practical belief in
the doctrines of the christian religion. Examples
of the divine efficacy of Christianity for this purpose,
have lately occurred in many parts of the United
States.

2. A sudden sense of the guilt contracted by
drunkenness, and of its punishment in a future

vol. i. 3 B

378 ON THE EFFECTS OF

world. It once cured a gentleman in Philadel-
phia, who, in a fit of drunkenness, attempted tQ
murder a wife whom he loved. Upon being told
of it when he was sober, he was so struck with the
enormity of the crime he had nearly committed,
that he never tasted spiritous liquors afterwards.

3. A sudden sense of shame. Of the efficacy
of this deep seated principle in the human bosom,
in curing drunkenness, I shall relate three remark-
able instances.

A farmer in England, who had been many years
in the practice of coming home intoxicated, from
a market town, one day observed appearances of
rain, while he was in market. His hay was cut,
and ready to be housed. To save it, he returned
in haste to his farm, before he had taken his cus-
tomary dose of grog. Upon coming into his
house, one of his children, a boy of six years old,
ran to his mother, and cried out, " O, mother!
father is come home, and he is not drunk." The
father, who heard this exclamation, was so se-
verely rebuked by it, that he suddenly became a
sober man.

A noted drunkard was once followed by a favou-
rite goat, to a tavern, into which he was invited by

ARDENT SPIRITS. 379

his master, and drenched with some of his liquor.
The poor animal staggered home with his master, a
good deal intoxicated. The next day he followed
him to his accustomed tavern. When the goat
came to the door, he paused : his master made signs
to him to follow him into the house. The goat
stood still. An attempt was made to thrust him
into the tavern. He resisted, as if struck with the
recollection of what he suffered from being intoxi-
cated the night before. His master wTas so much
affected by a sense of shame in observing the con-
duct of his goat to be so much more rational than
his own, that he ceased from that time to drink spi-
ritous liquors.

A gentleman, in one of the southern states, who
had nearly destroyed himself by strong drink, was
remarkable for exhibiting the grossest marks of
folly in his fits of intoxication. One evening, sit-
ting in his parlour, he heard an uncommon noise
in his kitchen. He went to the door, and peeped
through the key hole, from whence he saw one of
his negroes diverting his fellow servants, by mi-
micking his master's gestures and conversation
when he was drunk. The sight overwhelmed him
with shame and distress, and instantly became the
means of his reformation.

380 ON THE EFFECTS OF

4. The association of the idea of ardent spirits,
with a painful or disagreeable impression upon some
part of the body, has sometimes cured the love of
strong drink. I once tempted a negro man, who
was habitually fond of ardent spirits, to drink some
nun (which I placed in his way), and in which I
had put a few grains of tartar emetic. The tartar
sickened and puked him to such a degree, that he
supposed himself to be poisoned. I was much gra-
tified bv observing; he could not bear the sis-lit, nor
smell of spirits, for two years afterwards.

I have heard of a man, who was cured of the love
of spirits, by working off a puke, by large draughts
of brandy and water, and I know a gentleman, who
in consequence of being affected with a rheumatism,
immediately after drinking some toddy, when over-
come with fatigue and exposure to the rain, has
ever since loathed that liquor, only because it was
accidentally associated in his memory with the re-
collection of the pain he suffered from his disease.

This appeal to that operation of the human mind,
which obliges it to associate ideas, accidentally or
otherwise combined, for the cure of vice, is very
ancient. It was resorted to by Moses, when he
compelled the children of Israel to drink the solu-
tion of the golden calf (which they had idolized) in

ARDENT SPIRITS. 381

water. This solution, if made, as it most probably
was, by means of what is called hepar sulphuris, was
extremely bitter, and nauseous, and could never be
recollected afterwards, without bringing into equal
detestation, the sin which subjected them to the
necessity of drinking it. Our knowledge of this
principle of association upon the minds and conduct
of men, should lead us to destroy, by means of other
impressions, the influence of all those circumstances,
with which the recollection and desire of spirits are
combined. Some men drink only in the mornings
some at noon, and some only at night. Some men
drink only on a market day, some at one tavern
only, and some only in one kind of company. Now
by finding a new and interesting employment, or
subject of conversation for drunkards at the usual
times in which they have been accustomed to drink,
and by restraining them by the same means from
those places and companions, which suggested to
them the idea of ardent spirits, their habits of in-
temperance may be completely destroyed. In the
same way the periodical returns of appetite, and a
desire of sleep have been destroyed in a hundred
instances. The desire for strong drink differs from
each of them, in being of an artificial nature, and
therefore not disposed to return, after Ipeing chased
for a few week from the system.

382 ON THE EFFECTS OF

r

5. The love of ardent spirits has sometimes been
subdued, by exciting a counter passion in the mind.
A citizen of Philadelphia had made many unsuc-
cessful attempts to cure his wife of drunkenness.
At length, despairing of her reformation, he pur-
chased a hogshead of rum, and, after tapping- it,
left the key in the door of the room in which it was
placed, as if he had forgotten it. His design was
to give his wife an opportunity of drinking herself
to death. She suspected this to be his motive, in
what he had done, and suddenly left oif drinking.
Resentment here became the antidote to intemper-
ance.

6. A diet consisting wholly of vegetables cured
a physician in Maryland, of drunkenness, probably
by lessening that thirst, which is always more or
less excited by animal food.

7. Blisters to the ankles, which were followed by
an unusual degree of inflammation, once suspended
the love of ardent spirits, for one month, in a lady
in this city. The degrees of her intemperance may
be conceived of, when I add, that her grocer's ac-
compt for brandy alone amounted, annually, to one
hundred pounds, Pennsylvania currency, for seve-
ral years,

ARDENT SPIRITS. 383

8. A violent attack of an acute disease, has some-
times destroyed a habit of drinking distilled liquors.
I attended a notorious drunkard, in the yellow fe-
ver, in the year 1798, who recovered with the loss
of his relish for spirits, which has, I believe, con-
tinued ever since.

9. A salivation has lately performed a cure of
drunkenness, in a person of Virginia. The new
disease excited in the mouth and throat, while it
rendered the action of the smallest quantity of spi-
rits upon them painful, was happily calculated to
destroy the disease in the stomach which prompts
to drinking, as well as to render the recollection of
them disagreeable, by the laws of association for-
merly mentioned.

10. I have known an oath, taken before a magis-
trate, to drink no more spirits, produce a perfect
cure of drunkenness. It is sometimes cured in
this way in Ireland. Persons who take oaths for
this purpose are called affidavit men.

11. An advantage would probably arise from
frequent representations being made to drunkards,
not only of the certainty, but of the suddenness of
death, from habits of intemperance. I have heard
of two persons being cured of the love of ardent

384 ON THE EFFECTS, &X.

spirits, by seeing death suddenly induced by fits of
intoxication ; in the one case, in a stranger, and in
the other, in an intimate friend.

12. It has been said, that the disuse of spirits
should be gradual, but my observations authorize
me to say, that persons who have been addicted to
them, should abstain from them suddenly, and en-
tirely. u Taste not, handle not, touch not," should
be inscribed upon every vessel that contains spirits,
in the house of a man who wishes to be cured of
habits of intemperance. To obviate, for a while,
the debility which arises from the sudden abstrac-
tion of the stimulus of spirits, laudanum, or bit-
ters infused in water, should be taken, and perhaps
a larger quantity of beer or wine, that is consistent
with the strict rules of temperate living. By the
temporary use of these substitutes for spirits, I
have never known the transition to sober habits to
be attended with any bad effects, but often with
permanent health of body, and peace of mind.

.OBSERVATIONS

ON THE

DUTIES OF A PHYSICIAN,

AND THE METHODS OF

IMPROVING MEDICINE.

ACCOMMODATED TO THE PRESENT STATE OF SOCIETY
AND MANNERS IN THE UNITED STATES.

Delivered in the University of Pennsylvania, February 7, 1789, at the
conclusion of a course of lectures upon chemistry and the practice of
physic.

PUBLISHED AT THE REQUEST OF THE CLASS,

VOL. I. 3 c

OBSERVATIONS, &c.

GENTLEMEN,

I SHALL conclude our course of lectures,
by delivering to you a few directions for the regu-
lation of your future conduct and studies, in the
line of your profession.

I shall, first, suggest the most probable means
of establishing yourselves in business, and of be.,
coming acceptable to your patients, and respectable
in life.

Secondly , I shall mention a few thoughts which
have occurred to me on the mode to be pursued,
in the further prosecution of your studies, and far
the improvement of medicine.

388 OBSERVATIONS ON THE

I. Permit me, in the first place, to recommend

to such of you as intend to settle in the country,

to establish yourselves as early as possible upon

Jarms, My reasons for this advice are as follow :

1. It will reconcile the country people to the
liberality and dignity of your profession, by show-
ing them that you assume no superiority over them
from your education, and that you intend to share
with them in those toils, which were imposed upon
man in consequence of the loss of his innocence.
This will prevent envy, and render you acceptable
to your patients as men, as well as physicians.

2. By living on a farm you may serve your
country, by promoting improvements in agricul-
ture. Chemistry (which is now an important
branch of a medical education) and agriculture are
closely allied to each other. Hence some of the
r ost useful books upon agriculture have been
written by physicians. Witness the essays of Dr.
Home of Edinburgh, and of Dr. Hunter of York-
shire, in England.

3. The business of a farm will furnish you with
employment in the healthy seasons of the year, and
thereby deliver you from the taedium vitas, or what
is worse, from retreating to low or improper com-

DUTIES OF A PHYSICIAN* 389

pany. Perhaps one cause of the prevalence of dram
or grog drinking, with which country practitioners
are sometimes charged, is owing to their having
no regular or profitable business to employ them,
in the intervals of their attendance upon their pa-
tients.

4. The resources of a farm will create such an
independence as will enable you to practice with
more dignity, and at the same time screen you from
the trouble of performing unnecessary services to
your patients. It will change the nature of the
obligation between you and them. While money
is the only means of your subsistence, your pa-
tients will feel that they are the channels of your
daily bread ; but while your farm furnishes you
with the necessaries of life, your patients will feel
more sensibly, that the obligation is on their side,
for health and life.

5. The exigencies and wants of a farm in stock
and labour of all kinds, will enable you to obtain
from your patients a compensation for your ser-
vices in those articles. They all possess them,
and men part with that of which money is only
the sign, much more readily than they do with
money itself.

39(j OBSERVATIONS ON THE

6. The resources of a farm will prevent your
cherishing, for a moment, an impious wish for the
prevalence of sickness in your neighbourhood. A
healthy season will enable you to add to the pro-
duce of your farm, while the rewards of an un-
healthy season will enable you to repair the incon-,
venience of your necessary absence from it. By
these means your pursuits will be marked by that
variety and integrity, in which true happiness is
said to consist,

7. Let your farms be small, and let your prin-
cipal attention be directed to grass and horticulture.
These afford most amusement, require only mode-
rate labour, and will interfere least with vour du-
ties to your profession.

II. Avoid singularities of every kind in your
manners, dress, and general conduct. Sir Isaac
Newton, it is said, could not be distinguished in
company, by any peculiarity, from a common well-
bred gentleman. Singularity in any thing, is a
substitute for such great or useful qualities as com-
mand respect ; and hence we find it chiefly in little
minds. The profane and indelicate combination
of extravagant ideas, improperly called wit, and
the formal and pompous manner, whether accom-
panied by a wig, a cane, or a ring, should be all

<X>UTIES OF A PHYSICIAN. 3§1

avoided, as incompatible with the simplicity of sci-
ence, and the real dignity of physic. There is
more than one way of playing the quack. It is
not necessary, for this purpose, that a man should
advertise his skill, or his cures, or that he should
mount a phaeton and display his dexterity in ope-
rating, to an ignorant and gaping multitude. A
physician acts the same pail in a different way,
who assumes the character of a madman or a brute
in his manners, or who conceals his fallibility by
an affected gravity and taciturnity in his intercourse
with his patients. Both characters, like the quack,
impose upon the public. It is true, they deceive
different ranks of people ; but we must remember
that there are two kinds of vulgar, viz. the rich
and the poor; and that the rich vulgar are often
upon a footing with the poor, in ignorance and cre-
dulity.

III. It has been objected to our profession, that
many eminent physicians have been unfriendly to
Christianity. If this be true, I cannot help ascrib-
ing it in part to that neglect of public worship
with which the duties of our profession are often
incompatible ; for it has been justly observed^ that.
the neglect of this religious and social duty, gene-
rally produces a relaxation, cither in principles or
morals. Let this fact lead you, in setting out in

392 OBSERVATIONS ON THE

business, to acquire such habits of punctuality ill
visiting your patients, as shall not interfere with
acts of public homage to the Supreme Being. Dr.
Gregory has observed, that a cold heart is the
most frequent cause of deism. Where this occurs
in a physician, it affords a presumption that he is
deficient in humanity. But I cannot admit that
infidelity is peculiar to our profession. On the
contrary, I believe Christianity places among its
friends more men of extensive abilities and learning
in medicine, than in any other secular employment.
Stahl, Hoffman, Boerhaave, Sydenham, Haller,
and Fothergill, were all christians. These enlight-
ened physicians were considered as the ornaments
of the ages in which they lived, and posterity has
justly ranked them among the greatest benefactors
of mankind.

IV. Permit me to recommend to you a regard
to all the interests of your country. The educa-
tion of a physician gives him a peculiar insight
in the principles of many useful arts, and the prac-
tice of physic favours his opportunities of doing
good, by diffusing knowledge of all kinds. It
was in Rome, when medicine was practised only
by slaves, that physicians were condemned by their
profession " mutamexercereartem." But in mo-
dern times, and in free governments, they should

DUTIES OF A PHYSICIAN. 393

disdain an ignoble silence upon public subjects.
The American revolution has rescued physic from
its former slavish rank in society. For the honour
of our profession it should be recorded, that some
of the most intelligent and useful characters, both
in the cabinet and the field, during the late war,
have been physicians* The illustrious Dr. Fo-
thergill opposed faction and tyranny, and took the
lead in all public improvements in his native coun-
try, without suffering thereby the least diminution
of that reputation, or business, in which, for forty-
years, he flourished almost without a rival in the
city of London.

V. Let me advise you, in your visits to the
sick, never to appear in a hurry, nor to talk of
indifferent matters before you have made the ne-
cessary inquiries into the symptoms of your pa-
tient's disease.

VI. Avoid making light of any case. " Respice
finem" should be the motto of every indisposition.
There is scarcely a disease so trifling, that has not,
directly or indirectly, proved an outlet to human
life. This consideration should make you anxious
and punctual in your attendance upon every acute
disease, and keep you from risking your reputation
by an improper or hasty prognosis.

vol. i. 3 3

394 OBSERVATIONS ON THE

VII. Do not condemn, or oppose, unnecessarily,
the simple prescriptions of your patients. Yield
to them in matters of little consequence, but main-
tain an inflexible authority over them in matters
that are essential to life.

VIII. Preserve, upon all occasions, a composed
or cheerful countenance in the room of your pa-
tients, and inspire as much hope of a recovery as
you can, consistent with truth, especially in acute
diseases. The extent of the influence of the will
over the human body, has not yet been fully ascer-
tained. I reject the futile pretensions of Mr. Mes-
mer to the cure of diseases, by what he has ab-
surdly called animal magnetism. But I am willing
to derive the same advantages from his deceptions,
which the chemists have derived from the delusions
of the alchemists. The facts which he has estab-
lished, clearly prove the influence of the imagina-
tion, and will, upon diseases. Let us avail our-
selves of the handle which those faculties of the
mind present to us, in the strife between life and
death. I have frequently prescribed remedies of
doubtful efficacy in the critical stage of acute dis-
eases, but never till I had worked up my patients
into a confidence, bordering upon certainty, of
their probable good effects. The success of this
measure has much oftener answered, than disap-

BUTIES OF A PHYSICIAN. 395

pointed my expectations ; and while my patients
have commended the vomit, the purge, or the blis-
ter which was prescribed, I have been disposed to
attribute their recovery to the vigorous concur-
rence of the will in the action of the medicine.
Does the will beget insensibility to cold, heat, hun-
ger, and danger ? Does it suspend pain, and raise
the body above feeling the pangs of Indian tor-
tures? Let us not then be surprised that it should,
enable the system to resolve a spasm, to open an
obstruction, or to discharge an offending humour.
I have only time to hint at this subject. Perhaps
it would lead us, if we could trace it fully, to
some very important discoveries in the cure of
diseases.

IX. Permit me to advise you in your intercourse
with your patients, to attend to that principle in
the human mind, which constitutes the association
of ideas. A chamber, a chair, a curtain, or even
a cup, all belong to the means of life or death,
accordingly as they are associated with cheerful or
distressing ideas, in the mind of a patient. But
this principle is of more immediate application in
those chronic diseases which affect the mind.
Nothing can be accomplished here, till we pro-
duce a new association of ideas. For this purpose
a change of place and company are absolutely ne-

396 OBSERVATIONS ON THE

cessary. But we must sometimes proceed mucfy
further. I have heard of a gentleman in South-
Carolina who cured his fits of low spirits by chang-
ing his clothes. The remedy was a rational one.
It produced at once a new train of ideas, and thus
removed the paroxysm of his disease.

X. Make it a rule never to be angry at any
thing a sick man says or does to you. Sickness
often adds to the natural irritability of the temper.
We are, therefore, to bear the reproaches of our
patients with meekness and silence. It is folly to
resent injuries at any time, but it is cowardice to
resent an injury from a sick man, since, from his
weakness and dependence upon us, he is unable to
contend with us upon equal terms. You will find
it difficult to attach your patients to you by the ob-
ligations of friendship or gratitude. You will
sometimes have the mortification of being deserted
by those patients who owe most to your skill and
humanity. This led Dr. Turner to advise physi-
cians never to chuse their friends from among
their patients. But this advice can never be fol-
lowed by a heart that has been taught to love true
excellency, wherever it finds it. I would rather
advise you to give the benevolent feelings of your
hearts full scope, and to forget the unkind returns

OUTIES OF A PHYSICIAN. 397

they will often meet with, by giving to human nar
tare a tear.

XI. Avoid giving a patient over in an acute dis-
ease. It is impossible to tell in such cases where
life ends, and where death begins. Hundreds of
patients have recovered, who have been pro-
nounced incurable, to the great disgrace of our
profession. I know that the practice of predicting
danger and death upon every occasion, is some-
times made use of by physicians, in order to
enhance the credit of their prescriptions if their
patients recover, and to secure a retreat from
blame, if they should die. But this mode of act-
ing is mean and illiberal. It is not necessary that
we should decide with confidence at any time, up-
on the issue of a disease.

XII. A physician in sickness is always a wel-
come visitor in a family ; hence he is often solicited
to partake of the usual sign of hospitality in this
country, by taking a draught of some strong li-
quor, every time he enters into the house of a pa-
tient. Let me charge you to lay an early restraint
upon yourselves, by refusing to yield to this
practice, especially in the forenoon. Many phy-
sicians have been innocently led by it into habits
of drunkenness. You will be in the more danger

398 OBSERVATIONS ON THE

of falling into this vice, from the great fatigue and
inclemency of the weather to which you will be
exposed in country practice. But you have been
taught that strong drink affords only a temporary
relief from those evils, and that it afterwards ren-
ders the body more sensible of them.

XIII. I shall now give some directions with
respect to the method of charging for your services
to your patients.

When we consider the expence of a medical
education, and the sacrifices a physician is obliged
to make of ease, society, and even health, to his
profession ; and when we add to these, the con-
stant and painful anxiety which is connected witlv
the important charge of the lives of our fellow-
creatures, and above all, the inestimable value of
that blessing which is the object of his services, I
hardly know how it is possible for a patient suffi-
ciently and justly to reward his physician. But
when we consider, on the other hand, that sick-
ness deprives men of the means of acquiring mo-
ney ; that it increases all the expenses of living ;
and that high charges often drive patients from
regular-bred physicians to quacks ; I say, when
we attend to these considerations, we should make

BUTIES OF A PHYSICIAN. 399

our charges as moderate as possible, and conform
them to the following state of things.

Avoid measuring your services to your patients
by scruples, drachms, and ounces. It is an illibe-
ral mode of charging. On the contrary, let the
number and time of your visits, the nature of your
patient's disease, and his rank in his family or so-
ciety, determine the figures in your accounts. It
is certainly just to charge more for curing an apo-
plexy, than an intermitting fever. It is equally
justj to demand more for risking your life by visit-
ing a patient in a contagious fever, than for curing
a pleurisy. You have likewise a right to be paid
for your anxiety. Charge the same services, there-
fore, higher, to the master or mistress of a family,
or to an only son or daughter, who call forth all
your feelings and industry, than to less important
members of a family and of society. If a rich
man demand more frequent visits than are neces-
sary, and if he impose the restraints of keeping to
hours, by calling in other physicians to consult with
you upon eveiy trifling occasion, it will be just to
make him pay accordingly for it. As this mode
of charging is strictly agreeable to reason and equi-
ty, it seldom fails of according with the reason and
sense of equity of our patients. Accounts made
out upon these principles, are seldom complained

400 OBSERVATIONS ON THE

of by them. I shall only remark further upon this
subject, that the sooner you send in your accounts
after your patients recover, the better. It is the
duty of a physician to inform his patient of the
amount of his obligation to him at least once a
year. But there are times when a departure from
this rule may be necessary. An unexpected mis-
fortune in business, and a variety of other acci-
dents, may deprive a patient of the money he had
allotted to pay his physician. In this case, delica-
cy and humanity require, that he should not know
the amount of his debt to his physician, till time
had bettered his circumstances.

I shall only add, under this head, that the poor
of every description should be the objects of your
peculiar care. Dr. Boerhaave used to say, u they
" were his best patients, because God was their
" paymaster. " The first physicians that I have
known, have found the poor the steps by which
they have ascended to business and reputation.
Diseases among the lower class of people are gene-
rally simple, and exhibit to a physician the best
cases of all epidemics, which cannot fail of adding
to his ability of curing the complicated diseases of
the rich and intemperate. There is an inseparable
connection between a man's duty and his interest.
Whenever you are called, therefore, to visit a poor

DUTIES OF A PHYSICIAN. 401

patient, imagine you hear the voice of the good
Samaritan sounding in your ears, " Take care of
" him, and I will repay thee."

I come now to the second part of this address,
which was to point out the best mode to be pur-
sued, in the further prosecution of your studies,
and the improvement of medicine.

I. Give me leave to recommend to you, to open
all the dead bodies you can, without doing violence
to the feelings of your patients, or the prejudices
of the common people. Preserve a register of the
weather, and of its influence upon the vegetable
productions of the year. Above all, record the
epidemics of every season ; their times of appear-
ing and disappearing, and the connection of the
weather with each of them. Such records, if
published, will be useful to foreigners, and a trea-
sure to posterity. Preserve, likewise, an account
of chronic cases. Record the name, age, and oc-
cupation of your patient ; describe his disease ac-
curately, and the changes produced in it by your
remedies ; mention the doses of eveiy medicine
you administer to him. It is impossible to tell how
much improvement and facility in practice you
will find from following these directions. It has
been remarked, that physicians seldom rememb

r

VOL. I. 3 E

402 OBSERVATIONS ON THE

more than the two or three last years of their prac-
tice. The records which have been mentioned,
will supply this deficiency of memory, especially
in that advanced stage of life when the advice of
physicians is supposed to be most valuable.

II. Permit me to recommend to you further,
the study of the anatomy (if I may be allowed the
expression) of the human mind, commonly called
metaphysics. The reciprocal influence of the body
and mind upon each other, can only be ascer-
tained by an accurate knowledge of the faculties of
the mind, and of their various modes of combina-
tion and action. It is the duty of physicians to
assert their prerogative, and to rescue the mental
science from the usurpations of schoolmen and
divines. It can only be perfected by the aid and
discoveries of medicine. The authors I would
recommend to you upon metaphysics, are, Butler,
Locke, Hartley, Reid, and Beattie. These inge-
nious writers have cleared this sublime science of
its technical rubbish, and rendered it both intellir
gible and useful.

III. Let me remind you, that improvement in
medicine is not to be derived only from colleges
and universities. Systems of physic are the pro-
ductions of men of genius and learning ; but those
{acts which constitute real knowledge, are to be

DUTIES OF A PHYSICIAN. 403

met with in every walk of life. Remember how
many of our most useful remedies have been dis-
covered by quacks. Do not be afraid, therefore,
of conversing with them, and of profiting by their
ignorance and temerity in the practice of physic.
Medicine has its Pharisees, as well as religion.
But the spirit of this sect is as unfriendly to the
advancement of medicine, as it is to christian cha-
rity. By conversing with quacks, we may convey
instruction to them, and thereby lessen the mis-
chief they might otherwise do to society. But
further. In the pursuit of medical knowledge,,
let me advise you to converse with nurses and old
women. They will often suggest facts in the his-
tory and cure of diseases, which have escaped the
most sagacious observers of nature. Even ne-
groes and Indians have sometimes stumbled upon
discoveries in medicine. Be not ashamed to in-
quire into them. There is yet one more means
of information in medicine which should not be
neglected, and that is, to converse with persons
who have recovered from indispositions without
the aid of physicians. Examine the strength and
exertions of nature in these cases, and mark the
plain and home-made remedy to which they ascribe
their recovery. I have found this to be a fruitful
source of instruction, and have been led to con-
clude, that if every man in a city, or a district, could

404 OBSERVATIONS ON THE

be called upon to relate to persons appointed to re-
ceive and publish his narrative, an exact account of
the effects of those remedies which accident or
whim has suggested to him, it would furnish a very
useful book in medicine. To preserve the facts
thus obtained, let me advise you to record them in
a book to be kept for that purpose. There is one
more advantage that will probably attend the in-
quiries that have been mentioned : you may dis-
cover diseases, or symptoms of diseases, or even
laws of the animal economy, which have no place
in our systems of nosology, or in our theories of
physic.

IV. Study simplicity in the preparation of your
medicines. My reasons for this advice are as
follow :

1. Active medicines produce the most certain
effects in a simple state.

2. Medicines when mixed frequently destroy
the efficacy of each other. I do not include che-
mical medicines alone in this remark. It applies
likewise to Galenical medicines. I do not say, that
all these medicines are impaired by mixture, but
we can only determine when they are not, by actual
experiments and observations.

DUTIES OF A PHYSICIAN. 405

3. When medicines of the same class, or even
of different classes, are given together, the strongest
only produces an effect. But what are we to say
to a compound of two medicines which give ex-
actly the same impression to the system? Probably,
if we are to judge from analogy, the effect of them
will be such as would have been produced by nei-
ther, in a simple state.

4. By observing simplicity in your prescriptions,
you will always have the command of a greater
number of medicines of the same class, which may
be used in succession to each other, in proportion
as habit renders the system insensible of their action.

5. By using medicines in a simple state you will
obtain an exact knowledge of their virtues and
doses, and thereby be able to decide upon the nu-
merous and contradictory accounts which exist in
our books, of the character of the same medicines.

Under this head, I cannot help adding two more
directions.

1. Avoid sacrificing too much to the taste of
your patients in the preparation of your medicines.
The nature of a medicine may be wholly changed
by being mixed with sweet substances. The An-

406 OBSERVATIONS ON THE

thor of Nature seems to have had a design, in ren-
dering medicines unpalatable. Had they been
more agreeable to the taste, they would probably
have yielded long ago to the unbounded appetite
of man, and by becoming articles of diet, or con-
diments, have lost their efficacy in diseases.

2. Give as few medicines as possible in tinctures
made with distilled spirits. Perhaps there are few
cases in which it is safe to exhibit medicines pre-
pared in spirits, in any other form than in drops.
Many people have been innocently seduced into a
love of strong drink, from taking large or frequent
doses of bitters, infused in spirits. Let not our
profession be reproached in a single instance, with
adding to the calamities that have been entailed
upon mankind by this dreadful species of intempe-
rance.

V. Let me recommend to your particular at-
tention, the indigenous medicines of our country.
Cultivate or prepare as many of them as possible,
and endeavour to enlarge the materia medica, by
exploring the untrodden fields and forests of the
United States. The ipecacuanha, the Seneka and
Virginia snake-roots, the Carolina pink -root, the
spice-wood, the sassafras, the butter-nut, the tho-
roughwort, the poke, and the stramonium, are

DUTIES OF A PHYSICIAN. 407

but a small part of the medicinal productions of
America. I have no doubt but there are many
hundred other plants which now exhale invaluable
medicinal virtues in the desert air. Examine,
likewise, the mineral waters, which are so various
in their impregnation, and so common in all parts
of our country. Let not the properties of the
insects of America escape your investigation. We
have already discovered among some of them, a fly
equal in its blistering qualities to the famous fly
of Spain. Who knows but it may be reserved for
America to furnish the world, from her produc-
tions, with cures for some of those diseases which
now elude the power of medicine ? Who knows
but that, at the foot of the Allegany mountain,
there blooms a flower that is an infallible cure for
the epilepsy? Perhaps on the Monongahela, or
the Potowmac, there may grow a root that shall
supply, by its tonic powers, the invigorating effects
of the savage or military life in the cure of con-
sumptions. Human misery of every kind is evi-
dently on the decline. Happiness, like truth, is
a unit. While the world, from the progress of
intellectual, moral, and political truth, is becoming
a more safe and agreeable abode for man, the vo-
taries of medicine should not be idle. All the
doors and windows of the temple of nature have
been thrown open by the convulsions of the late

408 OBSERVATIONS, &X.

American revolution. This is the time, therefore,
to press upon her altars. We have already drawn
from them discoveries in morals, philosophy, and
government ; all of which have human happiness
for their object. Let us preserve the unity of
truth and happiness, by drawing from the same
source, in the present critical moment, a know-
ledge of antidotes to those diseases which are sup-
posed to be incurable.

I have now, gentlemen, only to thank you for
the attention with which you have honoured the
course of lectures which has been delivered to you,
and to assure you, that I shall be happy in render-
ing you all the services that lie in my power, in
any way you are pleased to command me. Accept
of my best wishes for your happiness, and may
the blessings of hundreds and thousands that were
ready to perish, be your portion in life, your com-
fort in death, and your reward in the world to
come.

AN

INQUIRY INTO THE CAUSE AND CURE

OF

SORE LEGS.

VOL. I. 3f

AN INQUIRY, &c.

HOWEVER trifling these complaints may-
appear, they compose a large class of the diseases
of a numerous body of people. Hitherto, the per-
sons afflicted by them have been too generally aban-
doned to the care of empirics, either because the
disease was considered as beneath the notice of
physicians, or because they were unable to cure it.
I would rather ascribe it to the latter, than to the
former cause, for pride has no natural fellowship
with the profession of medicine.

The difficulty of curing sore legs has been con-
fessed by physicians in every country. As far as
my observations have extended, I am disposed to
ascribe this difficulty to the uniform and indiscri-
minate mode of treating them, occasioned by the
want of a theory which shall explain their proxi-

412 ON SORE LEGS.

/

mate cause. I shall attempt in a few pages to de-
liver one, which, however imperfect, will, I hope,
lay a foundation for more successful inquiries upon
this subject hereafter.

I shall begin my observations upon this disease,,
by delivering and supporting the following propo-
sitions.

I. Sore legs are induced by general debility.
This I infer from the occupations and habits of the
persons who are most subject to them. They are
day-labourers, and sailors, who are in the habit of
lifting great weights ; also washer- women, and all
other persons, who pass the greatest part of their
time upon their feet. The blood-vessels and mus-
cular fibres of the legs are thus overstretched, by
which means either a rupture, or such a languid
action in the vessels is induced, as that an acciden-
tal wound from any cause, even from the scratch
of a pin, or the bite of a mosquito, will not easily
heal. But labourers, sailors, and washer-women
are not tiie only persons who are afflicted with
sore legs. Hard drinkers of every rank and de-
scription are likewise subject to them. Where
strong drink, labour, and standing long on the feet
are united, they more certainly dispose to sore legs,
than when they act separately. In China, where

ON SORE LEGS. 413

the labour which is performed by brutes in other
countries, is performed by men, varices on the legs
are very common among the labouring people.
Perhaps, the reason why the debility is induced in
the legs produces varices instead of ulcers in these
people, may be owing to their not adding the de-
bilitating stimulus of strong drink to that of exces-
sive labour.

It is not extraordinary that the debility produced
by intemperance in drinking ardent spirits, should
appear first in the lower extremities. The debi-
lity produced by intemperance in the use of wine,
makes its first appearance in the form of gout, in
the same part of the body. The gout, it is true,
discovers itself most frequently in pain only, but
there are cases in which it has terminated in ulcers,
and even mortifications on the legs.

II. Sore legs are connected with a morbid state
of the whole system. This I infer,

1. From the causes which induce them, all of
which act more or less upon every part of the body.

2. From their following or preceding diseases,
which obviously belong to the whole system. Fe-
vers and dysenteries often terminate critically in

414 ON SORE LEGS.

this disease ; and the pulmonary consumption and
apoplexy have often been preceded by the sup-
pression of a habitual discharge from a sore leg.
The two latter diseases have been ascribed to the
translation of a morbific matter to the lungs or
brain : but it is more rational to ascribe them to
a previous debility in those organs, by which
means their vessels were more easily excited into
action and effusion by the stimulus of the plethora,
induced upon the system in consequence of the
confinement of the fluids formerly discharged from
the leg in the form of pus. This plethora can do
harm only where there is previous debility ; for I
maintain that the system (when the solids are ex-
actly toned) will always relieve itself of a sudden
preternatural accumulation of fluids by means of
some natural emunctory. This h?.s been often ob-
served in the menorrhagia, which accompanies
plentiful living in women, and in the copious dis-
charges from the bowels and kidneys, which follow
a suppression of the perspiration.

3. I infer it, from their appearing almost uni-
versally in one disease, which is evidently a disease
of the whole system, viz. the scurvy.

4. From their becoming in some cases the out-
lets of menstrual blood, which is discharged in con-

ON SORE LEGS. 415

sequence of a plethora, which affects more or less
every part of the female system.

5. I infer it from the symptoms of sore legs,
which are in some cases febrile, and affect the pulse
in every part of the body with preternatural fre-
quency or force. These symptoms were witnessed,
in an eminent degree, in two of the patients who
furnished subjects for clinical remarks in the Penn-
sylvania hospital some years ago.

6. I infer that sore legs are a disease of the
whole system, from the manner in which they are
sometimes cured by nature and art. They often
prove the outlets of many general diseases, and all
the remedies which cure them, act more or less
upon the whole system.

In all cases of sore legs there is a tonic and atonic
state of the whole system. The same state of ex-
cessive or weak morbid action takes place in the
parts which are affected by the sores. The reme-
dies to cure them, therefore, should be general and
local.

In cases where the arterial system is affected by
too much tone, the general remedies should be,

'416 ON SORE LEGS.

I. Blood-letting. Of the efficacy of this re*
medy in disposing ulcers suddenly to heal, the two
clinical patients before-mentioned exhibited remark-
able proofs, in the presence of all the students of
medicine in the university. The blood drawn was
sizy in both cases. I have not the merit of having
introduced this remedy into practice in the cure of
ulcers. I learned it from Sir John Pringle. I have
known it to be used with equal success in a sore
breast, attended by pain and inflammation, after all
the usual remedies in that disease had been used to
no purpose.

II. Gentle purges.

III. Nitre. From fifteen to twenty grains of
this medicine should be given three times a- day,

IV. A temperate diet, and a total absti-
nence from fermented and distilled liquors.

V. Cool and pure air.

VI. Rest in a recumbent posture of the body.

The local remedies in this state of the system
should be,

ON SORE LEGS. 417

I. Cold water. Dr. Rigby has written largely
in favour of this remedy when applied to local in-
flammations. From its good effects in allaying the
inflammation which sometimes follows the punc-
ture which is made in the arm in communicating
the small-pox, and from the sudden relief it affords
in the inflammatory state of the ophthalmia and in
the piles, no one can doubt of its efficacy in sore
legs, accompanied by inflammation in those vessels,
which are the immediate seat of the disease.

II. Soft poultices of bread and milk, or of bread
moistened with lead water. Dr. Underwood's
method of making a poultice of bread and milk
should be preferred in this case. He directs us first
to boil the milk, then to powder the bread, and
throw it into the milk, and after they have been
intimately mixed, by being well stirred and boiled
together, they should be poured out and spread
upon a rag, and a knife dipped in sweet oil or lard,
should be run over them. The solidity and con-
sistence of the poultice is hereby better preserved,
than when the oil or lard is mixed with the bread
and milk over the fire.

III. When the inflammation subsides, adhesive
plasters so applied as to draw the sound edges of
the sores together. This remedy has been used

vol. i. 3 G

418 ON SORE LEGS.

with great success by Dr. Physick, in the Penn-
sylvania hospital, and in his private practice.

IV. Above all, rest, and a horizontal posture
of the leg. Too much cannot be said in favour
of this remedy in this species of sore legs. Nan-
noni, the famous Italian surgeon, sums up the cure
of sore legs in three words, viz. " Tempo, riposo,
" e paziensa ;" that is, in time, rest, and patience.
A friend of mine, who was cured by this surgeon
of a sore leg, many years ago, informed me, that
he confined him to his bed during the greatest part
of the time that he was under his care.

In sore legs, attended by too little general and
local action, the following remedies are proper.

I. Bark. It should be used plentifully, but
with a constant reference to the state of the system ;
for the changes in the weather, and other acciden-
tal circumstances, often produce such changes in the
system, as to render its disuse for a short time fre-
quently necessary.

II. Mercury. This remedy has been suppos-
ed to act by altering the fluids, or by discharging a
morbid matter from them, in curing sore legs. But
this is by no means the case. It appears to act as

ON SORE LEGS. 419

a universal stimulant ; and if it prove most useful
when it excites a salivation, it is only because in
this way it excites the most general action in the
system.

III. Mineral tonics, such as the different
preparations of iron, copper, and zinc.

IV. Gentle exercise. Rest, and a recum-
bent posture of the body, so proper in the tonic,
are both hurtful in this species of sore legs. The
efficacy of exercise, even of the active kind, in the
cure of sore legs, accompanied by deficient ac-
tion in the vessels, may easily be conceived from
its good effects after gun-shot wounds which are
mentioned by Dr. Jackson*. He tells us, that
those British soldiers who had been wounded at
the battle of Guilford, in North- Carolina, who
were turned out of the military hospitals and fol-
lowed the army, soonest recovered of their wounds.
It was remarkable, that if they delayed only a few
days on the road, their wounds grew worse, or
ceased to heal.

In the use of the different species of exercise,
the same regard should be had to the state of

* Medical Journal, 1790.

420 ON SORE LEGS.

the system, which has been recommended in other
diseases.

V. A nutritious and moderately stimulating diet,
consisting of milk, saccharine vegetables, animal
food, malt liquors, and wine.

Wort has done great service in sore leers. The
manner in which I have directed it to be prepared
and taken is as follows : To three or four heaped
table- spoonsful of the malt, finely powdered and
sifted, add two table- spoonsful of brown sugar, and
three or four of Madeira, sherry, or Lisbon wine,
and a quart of boiling water. After they have stood
a few hours, it may be drunken liberally by the pa-
tient, stirring it each time before he takes it, so that
the whole substance of the malt may be conveyed
into the stomach. A little lime-juice may be add-
ed, if the patient requires it, to make it more plea-
sant. The above quantity may be taken once,
twice, or three times a- day at the pleasure of the
patient, or according to the indication of his dis-
ease.

VI. Opium. This remedy is not only useful
in easing the pain of a sore leg, but co-operates
with other cordial medicines in invigorating the
whole system.

ON SORE LEGS. 421

The local applications should consist of such
substances as are gently escarotic, and which excite
an action in the torpid vessels of the affected part.
Arsenic, precipitate, and blue vitriol, have all been
employed with success for this purpose. Dr. Grif-
fitts informed me, that he has frequently accom-
plished the same thing in the Dispensary by ap-
plications of tartar emetic. They should all be
used, if necessary, in succession to each other ; for
there is often the same idiosyncrasy in a sore leg to
certain topical applications, that there is in the sto-
mach to certain aliments. After the use of these
remedies, astringents and tonics should be applied,
such as an infusion of Peruvian, or white-oak bark ;
the water in which the smiths extinguish their irons,
lime-water, bread dipped in a weak solution of green
vitriol (so much commended by Dr. Underwood),
compresses wetted with brandy, or ardent spirits
of any kind, and, above all, the adhesive plasters
formerly mentioned.

Tight bandages are likewise highly proper here.
The laced stocking has been much used. It is
made of strong coarse linen. Dr. Underwood gives
several good reasons for preferring a flannel rol-
ler to the linen stocking. It sets easier on the
leg, and yields to the swelling of the muscles in
walking.

422 ON SORE LEGS.

In scorbutic sores on the legs, navy surgeons
have spoken in high terms of an application of a
mixture of lime-juice and molasses. Mr. Gillebpie
commends the use of lime or lemon-juice alone, and
ascribes many cures to it in the British navy during
the late war, after every common application had
been used to no purpose*.

It is of the utmost consequence in the treatment
of sore legs, to keep them clean, by frequent dres-
sings and washings. The success of old women is
oftener derived from their great attention to cleanli-
ness, in the management of sore legs, than to any
specifics they possess which are unknown to physi-
cians.

When sore legs are kept from healing by affec-
tions of the bone, the treatment should be such as
is recommended by practical writers on surgery.

I shall conclude this inquiry by four observa-
tions, which are naturally suggested by what has
been delivered upon this disease.

1. If it has been proved that sore legs are con-
nected with a morbid state of the whole system, is

* Medical Journal, Vol. VI.

ON SORE LEGS. 423

it not proper to inquire, whether many other dis-
eases supposed to be local, are not in like manner
connected with the whole system ; and if sore legs
have been cured by general remedies, is it not pro-
per to use them more frequently in local diseases?

2. If there be two states of action in the arteries
in sore legs, it becomes us to inquire, whether the
same opposite states of action do not take place in
many diseases in which they are not suspected. It
would be easy to prove, that they exist in several
other local diseases.

3. If the efficacy of the remedies for sore legs
which have been mentioned, depend upon their
being accommodated exactly to the state of the ar-
terial system, and if this system be liable to fre-
quent changes, does it not become us to be more
attentive to the state of the pulse in this disease
than is commonly supposed to be necessary by phy-
sicians ?

4. It has been a misfortune in medicine, as well
as in other sciences, for men to ascribe effects to
one cause, which should be ascribed to man v.
Hence diseases have been attributed exclusively to
morbid affections of the fluids by some, and of the
muscles and nerves by others. Unfortunately the

424 ON SORE LEGS.

morbid states of the arterial system, and the influ-
ence of those states upon the brain, the nerves, the
muscles, the lymphatics, the glands, the viscera, the
alimentary canal, and the skin, as well as the reci-
procal influence of the morbid states of each of those
parts of the body upon the arteries, and upon each
other, have been too much neglected in most of our
systems of physic. I consider the pathology of the
arterial system as a mine. It was first discovered
by Dr. Cullen. The man who attempts to explore
it, will probably impoverish himself by his re-
searches ; but the men who come after him, will
certainly obtain from it a treasure which cannot fail
of adding greatly to the riches of medicine.

AN ACCOUNT

OF THE

STATE OF THE BODY AND MIND

IN OLD AGE ;

WITH

OBSERVATIONS ON ITS DISEASES,

AND THEIR REMEDIES.

VOL. I. 3k

AN ACCOUNT, &c.

MOST of the facts which I shall deliver
upon this subject, are the result of observations
made during the term of five years, upon persons of
both sexes, who had passed the 80th year of their

lives. I intended to have given a detail of the

names, manner of life, occupations, and other cir-
cumstances of each of them ; but, upon a review
of my notes, I found so great a sameness in the
history of most of them, that I despaired, by de-
tailing them, of answering the intention which I
have purposed in the following essay. I shall,
therefore, only deliver the facts and principles
which are the result of the inquiries and observa-
tions I have made upon this subject.

I. I shall mention the circumstances which fa-
vour the attainment of longevity.

428 ON OLD AGE.

II. I shall mention the phenomena of body and
mind which attend it ; and,

III. I shall enumerate its peculiar diseases, and
the remedies which are most proper to remove, or
moderate them.

I. The circumstances which favour longevity,
are,

1. Descent from long-lfoed ancestors. I have
not found a single instance of a person, who has
lived to be 80 years old, in whom this was not the
case. In some instances I found the descent was
only from one, but, in general, it was from both
parents. The knowledge of this fact, may serve,
not only to assist in calculating what are called the
chances of lives, but it may be made useful to a
physician. He may learn from it to cherish hopes
of his patients in chronic, and in some acute dis-
eases, in proportion to the capacity of life they
have derived from their ancestors*.

* Dr. Franklin, who died in his 84th year, was descend-
ed from long-lived parents. His father died at 89, and his
mother at 87. His father had 17 children by two wives.
The doctor informed me, that he once sat down as one of 1 1
adult sons and daughters at his father's table. In an excur-
sion he once made to that part of England from whence his

ON OLD AGE. 429

2. Temperance in eating and drinking. To
this remark I found several exceptions. I met
with one man of 84 years of age, who had been in-
temperate in eating ; and four or five persons who
had been intemperate in drinking ardent spirits.
They had all been day-labourers, or had deferred
drinking until they began to feel the languor of old
age. I did not meet with a single person who had
not, for the last forty or fifty years of their lives,
used tea, coffee, and bread and butter twice a day
as part of their diet. I am disposed to believe that
those articles of diet do not materially affect the
duration of human life, although they evidently
impair the strength of the system. The duration
©f life does not appear to depend so much upon the
strength of the body, or upon the quantity of its
excitability, as upon an exact accommodation of
stimuli to each of them. A watch spring will last
as long as an anchor, provided the forces which
are capable of destroying both, are always in an
exact ratio to their strength. The use of tea and
coffee in diet seems to be happily suited to the
change which has taken place in the human body,
by sedentary occupations, by which means less

family migrated to America, he discovered, in a grave-yard,
the tombstones of several persons of his name, who had liv-.
ed to be very old. These persons he supposed to have been
his ancestors.

430 ON OLD AGE.

nourishment and stimulus are required than for-
merly, to support animal life.

3. The moderate exercise of the understanding.
It has long been an established truth, that literary
men (other circumstances being equal) are longer
lived than other people. But it is not necessary
that the understanding should be employed upon
philosophical subjects to produce this influence up-
on human life. Business, politics, and religion,
which are the objects of attention of men of all
classes, impart a vigour to the understanding, which,
by being conveyed to every part of the body, tends
to produce health and long life.

•

4. Equanimity of temper. The violent and ir-
regular action of the passions tends to wear away
the springs of life.

Persons who live upon annuities in Europe have
bctii observed to be longer lived, in equal circum-
stances, than other people. This is probably occa-
sioned by their being exempted, by the certainty of
their subsistence, from those fears of want which
so frequently distract the minds, and thereby
weaken the bodies of old people. Life-rents have
been supposed to have the same influence in pro-
longing life. Perhaps the desire of life, in order to

ON OLD AGE. 431

enjoy for as long a time as possible, that property
which cannot be enjoyed a second time by a child
or relation, may be another cause of the longevity
of persons who live upon certain incomes. It is a
fact, that the desire of life js a very powerful stimu-
lus in prolonging it, especially when that desire is
supported by hope. This is obvious to physicians
every day. Despair of recovery, is the beginning
of death in all diseases.

But obvious and reasonable as the effects of
equanimity of temper are upon human life, there
are some exceptions in favour of passionate men
and women having attained to a great age. The
morbid stimulus of anger, in these cases, was pro-
bably obviated by less degrees, or less active exer-
cises of the understanding, or by the defect or
weakness of some of the other stimuli which keep
up the motions of life.

5. Matrimony, In the course of my inquiries
I met with only one person beyond eighty years
of age who had never been married. I met with

several women who had borne from ten to twenty

*

children, and suckled them all. I met with one
woman, a native of Herefordshire, in England, who
was in the 100th year of her age, who had borne
a child at 60, menstruated till 80, and frequently

432 ON OLD AGE.

suckled two of her children (though bom in succes-
sion to each other) at the same time. She had
passed the greatest part of her life over a washing-
tub.

6. Emigration. I have observed many instances
of Europeans who have arrived in America in the
decline of life, who have acquired fresh vigour
from the impression of our climate, and of new ob-
jects upon their bodies and minds ; and whose lives,
in consequence thereof, appeared to have been pro-
longed for many years. This influence of climate
upon longevity is not confined to the United States.
Of 100 European Spaniards, who emigrate to
South- America in early life, 18 live to be above
50, whereas but 8 or 9 native Spaniards, and but
7 Indians of the same number, exceed the 50th
year of human life.

7. I have not found sedentary employments to
prevent long life, where they are not accompanied
by intemperance in eating or drinking. This ob-
servation is not confined to literary men, nor to
women only, in whom longevity, without much
exercise of body, has been frequently observed. I
met with one instance of a weaver ; a second of a
silver-smith ; and a third of a shoe-maker, among

0N OLD AGE. 433

the number of old people, whose histories have sug-
gested these observations.

8. I have not found that acute , nor that all chro-
nic diseases shorten human life. Dr. Franklin had
two successive vomicas in his lungs before he was
40 years old. I met with one man beyond 80,
who had survived a most violent attack of the yel-
low fever ; a second who had had several of his
bones fractured by falls, and in frays ; and many
who had been frequently affected by intermittent.
I met with one man of 86, who had all his life been
subject to syncope ; another who had for 50 years
been occasionally affected by a cough* ; and two
instances of men who had been afflicted for forty
years with obstinate head-achsf . I met with only
one person beyond 80, who had ever been affected
by a disease in the stomach; and in him it arose-
from an occasional rupture. Mr. John Strange-
ways Hutton, of this city, who died in 1793, in
the 109th year of his age, informed me, that he

* This man's only remedy for his cough was the fine
powder of dry Indian turnip and honey.

t Dr. Thiery says, that he did not find the itch, or slight
degrees of the leprosy, to prevent longevity. Observations
de Physique, et de Medecine faites en differens lieux de
L'Espagne. Vol II. p. 17 i.

VOL. I. 3 I

434 ON OLD AGE.

had never puked in his life. This circumstance is
the more remarkable, as he passed several years at
sea when a young man*. These facts may serve
to extend our ideas of the importance of a healthy
state of the stomach in the animal economy ; and
thereby to add to our knowledge in the prognosis
of diseases, and in the chances of human life.

9. I have not found the loss of teeth to affect the
duration of human life, so much as might be ex-
pected. Edward Drinker, who lived to be 103

* The venerable old man, whose history first suggested
this remark, was born in New-York in the year 1684. His
grandfather lived to be 101, but was unable to walk for thirty
years before he died, from an excessive quantity of fat. His
mother died at 91. His constant drinks were water, beer,
and cyder. He had a fixed dislike to spirits of all kinds.
His appetite was good, and he ate plentifully during the last
years of his life. He seldom drank any thing between his
meals. He was never intoxicated but twice in his life, and
that was when a boy, and at sea, where he remembers per-
fectly well to have celebrated, by a feu de joye, the birth-day
of queen Anne. He was formerly afflicted with the head-
ach and giddiness, but never had a fever, except from the
small- pox, in the course of his life. His pulse was slow, but
regular. He had been twice married. By his first wife he
had eight, and by his second seventeen children. One of
them lived to be 83 years of age. He was about five feet
nine inches in height, of a slender make, and carried an
erect head to the last year of his life.

ON OLD AGE. 435

years old, lost his teeth thirty years before he died,
from drawing the hot smoke of tobacco into his
mouth through a short pipe.

Dr. Sayre of New-Jersey, to whom I am in-
debted for several very valuable histories of old
persons, mentions one man aged 81, whose teeth
began to decay at 15, and another of 90, who lost
his teeth, thirty years before he saw him. The
gums, by becoming hard, perform, in part, the
office of teeth. But may not the gastric juice of
the stomach, like the tears and urine, become acrid
by age, and thereby supply, by a more dissolving
power, the defect of mastication from the loss of
teeth? Analogies might easily be adduced from
several operations of nature, which go forward in
the animal economy, which render this supposition
highly probable.

10. I have not observed baldness, or grey hairs,
occurring in early or middle life, to prevent oid
age. In one of the histories furnished me by Dr.
Sayre, I find an account of a man of 81, whose
hair began to assume a silver colour when he was
but one and twenty years of age.

11. More women live to be old than men, but
more men live to be very old, than women.

436 ON OLD AGE.

I shall conclude this head by the following re-
mark :

Notwithstanding there appears in the human
body a certain capacity of long life, which seems
to dispose it to preserve its existence in every situa-
tion ; yet this capacity does not always protect it
from premature destruction ; for among the old
people whom I examined, I scarcely met with one
who had not lost brothers or sisters, in early and
middle life, and who were born under circum-
stances equally favourable to longevity with them-
selves.

II. I now come to mention some of the pheno-
mena of the body and mind which occur in old age.

1. There is a great sensibility to cold in all old
people. I met with an old woman of 84, who slept
constantly under three blankets and a coverlet du-
ring the hottest summer months. The servant of
prince de Beaufremont, who came from Mount
Jura to Paris, at the age of 121, to pay his respects
to the first national assembly of France, shivered
with cold in the middle of the dog days, when he
was not near a good fire. The national assembly
directed him to sit with his hat on, in order to de-
fend his head from the cold.

ON OLD AGE. 437

2. Impressions made upon the ears of old peo-
ple, excite sensation and reflection much quicker
than when they are made upon their eyes. Mr.
Hutton informed me, that he had frequently met
his sons in the street without knowing them, until
they had spoken to him. Dr. Franklin informed
me, that he recognized his friends, after a long ab-
sence from them, first by their voices. This fact
does not contradict the common opinion, upon the
subject of memory, for the recollection, in these in-
stances, is the effect of what is called reminiscence,
which differs from memoiy in being excited only
by the renewal of the impression which at first pro-
duced the idea which is revived.

3. The appetite for food is generally increased in
old age. The famous Parr, who died at 152, ate
heartily in the last week of his life. The kindness
of nature, in providing this last portion of earthly
enjoyments for old people, deserves to be noticed.
It is remarkable, that they have, like children, a
frequent recurrence of appetite, and sustain with
great uneasiness the intervals of regular meals.
The observation, therefore, made by Hippocrates,
that middle-aged people are more affected by ab-
stinence than those who are old, is not true. This
might easily be proved by many appeals to the re-
cords of medicine; but old people differ from

438 ON OLD AGE.

children, in preferring solid to liquid aliment.
From inattention to this fact, Dr. Mead has done
great mischief by advising old people, as their teeth
decayed or perished, to lessen the quantity of
their solid, and to increase the quantity of their
liquid food. This advice is contrary to nature
and experience, and I have heard of two old per-
sons who destroyed themselves by following it.
The circulation of the blood is supported in old
people chiefly by the stimulus of aliment. The
action of liquids of all kinds upon the system is
weak, and of short continuance, compared with the
durable stimulus of solid food. There is a grada-
tion in the action of this food upon the body.
Animal matters are preferred to vegetable ; the
fat of meat to the lean, and salted meat to fresh,
by most old people. I have met with but few old
people who retained an appetite for milk. It is
remarkable, that a less quantity of strong drink
produces intoxication in old people than in persons
in the middle of life. This depends upon the re-
currence of the same state of the system, with
respect to excitability, which takes place in child-
hood. Many old people, from an ignorance of
this fact, have made shipwreck of characters which
have commanded respect in every previous stage
of their lives. From the same recurrence of the
excitability of childhood in their systems, they

ON OLD AGE. 439

commonly drink their tea and coffee much weaker
than in early or middle life.

4. The pulse is generally full, and frequently
affected by pauses in its pulsations when felt in the
wrists of old people. A regular pulse in such per-
sons indicates a disease, as it shows the system to
be under the impression of a preternatural stimulus
of some kind. This observation was suggested to
me above thirty years ago by Morgagni, and I
have often profited by it in attending old people.
The pulse in such patients is an uncertain mark of
the nature, or degree of an acute disease. It sel-
dom partakes of the quickness or convulsive action
of the arterial system, which attends fever in young
or middle-aged people. I once attended a man of
77 in a fever of the bilious kind, which confined
him for eight days to his bed, in whom I could not
perceive the least quickness or morbid action in his
pulse until four and twenty hours before he died.

5. The marks of old age appear earlier, and are
more numerous in persons who have combined
with hard labour, a vegetable or scanty diet, than
in persons who have lived under opposite circum-
stances. I think I have observed these marks of
old age to occur sooner, and to be more numerous
in the German, than in the English or Irish citi-

440 ON OLD A&jE.

zens of Pennsylvania. They are likewise more
common among the inhabitants of country places,
than of cities, and still more so among the Indians
of North- America, than among the inhabitants of
civilized countries.

6. Old men tread upon the whole base of their
feet at once in walking. This is perhaps one rea-
son why they wear out fewer shoes, under the same
circumstances of constant use, than young people,
who, by treading on the posterior, and rising on
the anterior part of their feet, expose their shoes
to more unequal pressure and friction. The ad-
vantage derived to old people from this mode of
walking is very obvious. It lessens that disposi-
tion to totter, which is always connected with weak-
ness : hence we find the same mode of walking is
adopted by habitual drunkards, and is sometimes
from habit practised by them, when they are not
under the influence of strong drink.

7. The breath and perspiration of old people
have a peculiar acrimony, and their urine, in some
instances, emits a foetor of an offensive nature.

8. The eyes of very old people sometimes change
from a dark and blue, to a light colour.

ON OLD AGE. 441

9. The memory is the first faculty of the mind
which fails in the decline of life. While recent
events pass through the mind without leaving an
impression upon it, it is remarkable that the long
forgotten events of childhood and youth are recalled
and distinctly remembered.

I met with a singular instance of a German wo*
man, who had learned to speak the language of our
country after she was forty years of age, who had
forgotten every word of it after she had passed her
80th year, but spoke the German language as flu-
ently as ever she had done. The memory decays
soonest in hard drinkers. I have observed some
studious men to suffer a decay of their memories,
but never of their understandings. Among these
was the late Anthony Benezet of this city. But
even this infirmity did not abate the cheerfulness,
nor lessen the happiness of this pious philosopher,
for he once told me, when I was a young man,
that he had a consolation in the decay of his me-
mory, which gave him a great advantage over me.
" You can read a good book (said he) with plea-
" sure but ojice, but when I read a good book, I
" so soon forget the contents of it, that I have the
" pleasure of reading it over and over ; and every
" time I read it, it is alike new and delightful to
" me." The celebrated Dr. Swift was one of

vol. i. 3 K

442 ON OLD AGE.

those few studious men, who have exhibited marks
of a decay of understanding in old age ; but it is
judiciously ascribed by Dr. Johnson to two causes
which rescue books, and the exercise of the think-
ing faculties from having had any share in inducing
that disease upon his mind. These causes were,
a rash vow which he made when a young man,
never to use spectacles, and a sordid seclusion of
himself from company, by which means he was cut
off from the use of books, and the benefits of con-
versation, the absence of which left his mind with-
out its usual stimulus : hence it collapsed into a
state of fatuity. It is probably owing to the con-
stant exercise of the understanding, that literary
men possess that faculty of the mind in a vigorous
state in extreme old age. The same cause accounts
for old people preserving their intellects longer in
cities, than in country places. They enjoy society
upon such easy terms in the former situation, that
their minds are kept more constantly in an excited
state by the acquisition of new, or the renovation
of old ideas, by means of conversation.

10. I did not meet with a single instance in
which the moral or religious faculties were impair-
ed in old people. I do not believe, that these fa-
culties of the mind are preserved by any supernatu-
ral power, but wholly by the constant and increasing

ON OLD AGE. 443

Exercise of them in the evening of life. In the
course of my inquiries, I heard of a man of 101
years of age, who declared that he had forgotten
every thing he had ever known, except his God.
I found the moral faculty, or a disposition to do
kind offices to be exquisitely sensible in several old
people, in whom there was scarcely a trace left of
memory or understanding.

11. Dreaming is universal among old people.
It appears to be brought on by their imperfect sleep,
of which I shall say more hereafter.

12. I mentioned formerly the sign of a second
ehildhood in the state of the appetite in old people.
It appears further, 1. In the marks which slight
contusions or impressions leave upon their skins.
2. In their being soon fatigued by walking or exer-
cise, and in being as soon refreshed by rest. 3. In
their disposition, like children, to detail immediately
every thing they see and hear. And, 4. In their
aptitude to shed tears ; hence they are unable to
tell a story that is in any degree distressing without
weeping. Dr. Moore takes notice of this pecu-
liarity in Voltaire, after he had passed his 80th
year. He wept constantly at the recital of his
own tragedies. This feature, in old age, did not
escape Homer. Old Menelaus wept ten years af-

444 ON OLD AGE.

ter he returned from the destruction of Troy, when
he spoke of the death of the heroes who perished
before that city.

13. It would be sufficiently humbling to human
nature, if our bodies exhibited in old age the marks
only of a second childhood ; but human weakness
descends still lower. I met with an instance of a
woman between 80 and 90, who exhibited the
marks of a second infancy ', by such a total decay of
her mental faculties, as to lose all consciousness in
discharging her alvine and urinary excretions. In
this state of the body, a disposition to sleep, suc-
ceeds the wakefulness of the first stages of old age.
Dr. Haller mentions an instance of a very old man
who slept twenty, out of every twenty-four hours
during the few last years of his life.

14. The disposition in the system to renew cer-
tain parts in extreme old age, has been mentioned
by several authors. Many instances are to be met
with in the records of medicine of the sight* and

* There is a remarkable instance of the sight having been
restored after it had been totally destroyed in an old man
near Reading, in Pennsylvania. My brother, Judge Rush,
furnished me with the following account of him in a letter
trom Reading, dated June 23, 1792.

• N OLD AGE. 445

hearing having been restored, and even of the teeth
having been renewed in old people a few years be-
fore death. These phenomena have led me to sus-
pect that the antediluvian age was attained by the
frequent renovation of different parts of the body,
and that when they occur, they are an effort of the
causes which support animal life, to produce ante-
diluvian longevity, by acting upon the revived ex-
citability of the system.

15. The fear of death appears to be much less
in old age, than in early, or middle life. I met
with many old people who spoke of their dissolu-
tion with composure, and with some who expres-

" An old man, of 84 years of age, of the name of Adam.
Riffle, near this town, gradually lost his sight in the 68th
year of his age, and continued entirely blind for the space of
twelve years. About four years ago his sight returned, with-
out making use of any means for the purpose, and without
any visible change in the appearance of the eyes, and he now
sees as well as ever he did. I have seen the man, and have
no doubt of the fact. He is at this time so hearty, as to be
able to walk from his house to Reading (about three miles),
which he frequently does in order to attend church. I should
observe, that during both the gradual loss, and recovery of
his sight, he was no ways affected by sickness, but, on the
contrary, enjoyed his usual health. I have this account from
his daughter and son-in-law, who live within a few doors
of me."

446 ON OLD AGE.

sed earnest desires to lie down in the grave. This
indifference to life, and desire for death (whether
they arise from a satiety in worldly pursuits and
pleasures, or from a desire of being relieved from
pain) appear to be a wise law in the animal econo-
my, and worthy of being classed with those laws
which accommodate the body and mind of man to
all the natural evils, to which, in the common or-
der of things, they are necessarily exposed.

III. I come now briefly to enumerate the dis-
eases of old age, and the remedies which are most
proper to remove, or to mitigate them.

The diseases are chronic and acute. The chro-
nic are,

1. Weakness of the knees and ancles ■, a lessened
ability to walk, and tremors in the head and limbs.

2. Pains in the bones, known among nosologi-
cal writers by the name of rheumatalgia.

3. Involuntary flow of tears, and of mucus from
the nose.

4. Difficulty of breathing, and a short cough,
with copious expectoration. A weak, or hoarse
voice generally attends this cough.

ON OLD AGE. 447

5. Costheness.

6. An inability to retain the urine as long as in
early or middle life. Few persons beyond 60 pass
a whole night without being obliged to discharge
their urine*. Perhaps the stimulus of this liquor
in the bladder may be one cause of the universality
of dreaming among old people. It is certainly a
frequent cause of dreaming in persons in early and
middle life : this I infer, from its occuring chiefly
in the morning when the bladder is most distended
with urine. There is likewise an inability in old
people to discharge their urine as quickly as in
early life. I think I have observed this to be among
the first symptoms of the declension of the strength
of the body by age.

7. Wakefulness, This is probably produced in
part by the action of the urine upon the bladder ;
but such is the excitability of the system in the
first stages of old age, that there is no pain so light,
no anxiety so trifling, and no sound so small, as not
to produce wakefulness in old people. It is owing
to their imperfect sleep, that they are sometimes as

* I met with an old man, who informed me, that if from
any accident he retained his urine after he felt an inclination
to discharge it, he was affected by a numbness, accompanied
by an uneasy sensation in the palms of his hands.

448 ON OLD AGE,

unconscious of the moment of their passsing from a
sleeping to a waking state, as young and middle-
aged people are of the moment in which they pass
from the waking to a sleeping state. Hence Ave so
often hear them complain of passing sleepless nights.
This is no doubt frequently the case, but I am sa-
tisfied, from the result of an inquiry made upon this
subject, that they often sleep without knowing it,
and that their complaints in the morning, of the
want of sleep, arise from ignorance, without the
least intention to deceive.

8. Giddiness.

9. Deafness,

10. Imperfect vision.

The acute diseases most common among old
people, are,

1. Inflammation of the eyes.

2. The pneumonia notha, or bastard peripneu-
mony.

3. The colic.

Off OLD AGE. 449

4. Palsy and apoplexy.-

5. The piles*

6. A difficulty in making water.

7. Quartan fever.

All the diseases of old people, both chronic and
acute, originate in predisposing debility. The re-
medies for the former, where a feeble morbid ac-
tion takes place in the system, are stimulants. The
first of these is,

I. Heat. The ancient Romans prolonged life
by retiring to Naples, as soon as they felt the infir-
mities of age coming upon them. The aged
Portuguese imitate them, by approaching the warm
sun oi Brazil, in South- America. But heat may
be applied to the torpid bodies of old people artifi-
cially. 1st. By means of the warm bath. Dr.
Franklin owed much of the cheerfulness and gene-
ral vigour of body and mind which characterised
his old age, to his regular use of this remedy. It
disposed him to sleep, and even produced a respite
from the pain of the stone, with which he was af-
flicted during the last years of his life.

vol. i. 3 L

450 ON OLD AGE.

2. Heat may be applied to the bodies of old peo-
ple by means of stove rooms. The late Dr. Dewit,
of Germantown, who lived to be near 100 years of
age, seldom breathed an air below 72°, after he be-
came an old man. He lived constantly in a stove-
room.

3. Warm clothing, more especially warm bed-
clothes, are proper to preserve or increase the heat
of old people. From the neglect of the latter, they
are often found dead in their beds in the morning,
after a cold night, in all cold countries. The late
Dr. Chovet, of this city, who lived to be 85, slept
in a baize night-gown, under eight blankets, and a
coverlet, in a stove-room, many years before he
died. The head should be defended in old people,
by means of woollen, or fur caps, in the night, and
by wigs and hats during the day, in cold weather.
These artificial coverings will be the more neces-
sary, where the head has been deprived of its na-
tural covering. Great pains should be taken like-
wise to keep the feet dry and warm, by means of
thick shoes*. To these modes of applying and

* I met with one man above 80, who defended his feet
from moisture by covering his shoes in wet weather with
melted wax ; and another who, for the same purpose, co-
vered his shoes every morning with a mixture composed of
the following ingredients melted together: lintseed oil a

ON OLD AGE. 451

confining heat to the bodies of old people, a young
bed-fellow has been added; but I conceive the
three artificial modes which have been recommend-
ed, will be sufficient without the use of one, which
cannot be successfully employed without a breach
of delicacy or humanity.

II. To keep up the action of the system, gene-
rous diet and drinks should be given to old
people. For a reason mentioned formerly, they
should be indulged in eating between the ordinary
meals of families. Wine should be given to them
in moderation. It has been emphatically called
the milk of old age.

III. Young company should be preferred by
old people to the company of persons of their own
age. I think I have observed old people to enjoy
better health and spirits, when they have passed

pound, mutton suet eight ounces, bees-wax six ounces, and
rosin four ounces. The mixture should be moderately
warmed, and then applied not only to the upper leather,
but to the soles of the shoes. This composition, the old
gentleman informed me, was extracted from a book entitled,
" The Complete Fisherman," published in England, in the
reign of queen Elizabeth. He had used it for twenty years
in cold and wet weather, with great benefit, and several of
his friends, who had tried it, spoke of its efficacy in keeping
the feet dry, in high terms.

452 ON OLD AGE.

the evening of their lives in the families of their
children, where they have been surrounded by
grand- children, than when they lived by them-
selves. Even the solicitude they feel for the wel-
fare of their descendants, contributes to invigorate
the circulation of the blood, and therebv to add fuel
to the lamp of life.

IV. Gentle exercise. This is of great
consequence in promoting the health of old people.
It should be moderate, regular, and always in fair
weather.

V. Cleanliness. This should by no means
be neglected. The dress of old people should not
only be clean, but more elegant than in youth or
middle life. It serves to divert the eye of specta-
tors from observing the decay and deformity of the
body, to view and admire that which is always
agreeable to it,

VI. To abate the pains of the chronic rheuma-
tism, and the uneasiness of the old man's cough (as
it is called) ; also to remove wakefulness, and to
restrain, during the night, a troublesome inclina-
tion to make water, opium may be given with
great advantage. Chardin informs us, that this
medicine is frequently used in the eastern countries

ON OLD AGE. 453

to abate the pains and weaknesses of old age, by
those people who are debarred the use of wine by
the religion of Mahomet.

I have nothing to say upon the acute diseases of
old people, but what is to be found in most of our
books of medicine, except to recommend bleed-
ing in those of them which are attended with ple-
thora, and an inflammatory action in the pulse.
The degrees of appetite which belong to old age,
the quality of the food taken, and the sedentary
life which is generally connected with it, all con-
Cur to produce that state of the system, which re-
quires the above evacuation. I am sure that I have
seen many of the chronic complaints of old people
mitigated by it, and I have more than once seen it
used with obvious advantage in their inflammatory
diseases. These affections I have observed to be
more fatal among old people than is generally sup-
posed. An inflammation of the lungs, which ter-
minated in an abscess, deprived the world of Dr.
Franklin. Dr. Chovet died of an inflammation in
his liver. The blood drawn from him a few days
before his death was sizy, and such was the heat
of his body, produced by his fever, that he could
not bear more covering (notwithstanding his for-
mer habits of warm clothing) than a sheet in the
month of January.

454 ©N OLD AGE.

Death from old age is the effect of a gradual
palsy. It shows itself first in the eyes and ears, in
the decay of sight and hearing ; it appears next in
the urinary bladder, in the limbs and trunk of the
body ; then in the sphincters of the bladder and
rectum ; and finally in the nerves and brain, de-
stroying in the last, the exercise of all the faculties
of the mind.

Few persons appear to die of old age. Some
one of the diseases which have been mentioned,
generally cuts the last thread of life.

END OF VOLUME I.